O'Bies Adobe, LLC

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

License

10078143 Issued in AK

Legal business name

O'BIES ADOBE, LLC

Doing business as

O'Bies Adobe, LLC

Practice address

1790 N Centurian PL Apt 3
Wasilla, AK 99654-5470

Phone

(907) 244-6929

NPI assigned

Aug 31, 2018

Last updated

Aug 31, 2018By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Charles Edward O'Bryan Jr.

Title

Owner/Administrator

Phone

(907) 244-6929

Specialties & licenses 1

Addresses

Other names 1

• O'Bies Adobe, LLC Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1535673600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1535673600000",
    "number": "1255813655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4128 E COUNTRY FIELD CIR",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996546665",
            "telephone_number": "907-244-6929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1790 N CENTURIAN PL APT 3",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996545470",
            "telephone_number": "907-244-6929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "O'BIES ADOBE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-31",
        "last_updated": "2018-08-31",
        "status": "A",
        "authorized_official_last_name": "O'BRYAN",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "EDWARD",
        "authorized_official_title_or_position": "OWNER/ADMINISTRATOR",
        "authorized_official_telephone_number": "907-244-6929",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "AK",
            "license": "10078143",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "O'Bies Adobe, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Wasilla, AK
• Providers in Wasilla, AK by specialty
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.