Birchwood Assisted Living Home, LLC

Primary specialty

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

Legal business name

BIRCHWOOD ASSISTED LIVING HOME, LLC

Practice address

19619 Crabtree St
Chugiak, AK 99567-5922

Phone

(907) 529-1088

NPI assigned

Oct 17, 2019

Last updated

Oct 17, 2019By 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

Yael Sarah Martin Hickok

Title

Owner

Phone

(907) 529-1088

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1571270400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1571270400000",
    "number": "1467095836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19619 CRABTREE ST",
            "city": "CHUGIAK",
            "state": "AK",
            "postal_code": "995675922",
            "telephone_number": "907-529-1088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19619 CRABTREE ST",
            "city": "CHUGIAK",
            "state": "AK",
            "postal_code": "995675922",
            "telephone_number": "907-529-1088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BIRCHWOOD ASSISTED LIVING HOME, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-17",
        "last_updated": "2019-10-17",
        "status": "A",
        "authorized_official_last_name": "HICKOK",
        "authorized_official_first_name": "YAEL",
        "authorized_official_middle_name": "SARAH MARTIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "907-529-1088"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Providers in Chugiak, 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 Oct 17, 2019; 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.