Willow Personal Care Assistants, LLC

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

Legal business name

WILLOW PERSONAL CARE ASSISTANTS, LLC

Practice address

Mile 69. 1 Parks Highway
Willow, AK 99688

Phone

(907) 495-6778

Fax

(907) 495-6779

NPI assigned

Nov 25, 2009

Organization subpart

No

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

Authorized official

Name

Mr. Thomas Dahlen, MBA, CNA

Title

Owner

Phone

(907) 495-6778

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1259107200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1259107200000",
    "number": "1285962464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 624",
            "city": "WILLOW",
            "state": "AK",
            "postal_code": "996880624",
            "telephone_number": "907-495-6778",
            "fax_number": "907-495-6779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MILE 69. 1 PARKS HIGHWAY",
            "city": "WILLOW",
            "state": "AK",
            "postal_code": "99688",
            "telephone_number": "907-495-6778",
            "fax_number": "907-495-6779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLOW PERSONAL CARE ASSISTANTS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-11-25",
        "last_updated": "2009-11-25",
        "status": "A",
        "authorized_official_last_name": "DAHLEN",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "907-495-6778",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MBA, CNA"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Virginia N Wodkowski

• All providers in Willow, AK
• In Home Supportive Care Agency in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2009; 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.