Primrose Senior Holdings, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

PRIMROSE SENIOR HOLDINGS, LLC

Practice address

889 N. Elkhorn Drive
Wasilla, AK 99654

Phone

(907) 373-5500

Fax

(605) 725-8754

NPI assigned

May 1, 2009

Organization subpart

No

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

Authorized official

Name

Becky Dutenhoffer

Title

Operations Specialist

Phone

(605) 725-3859

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Primrose Retirement Community of Wasilla Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

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

{
    "created_epoch": "1241136000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1652313600000",
    "number": "1467696641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "889 N. ELKHORN DRIVE",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "99654",
            "telephone_number": "907-373-5500",
            "fax_number": "605-725-8754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "889 N. ELKHORN DRIVE",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "99654",
            "telephone_number": "907-373-5500",
            "fax_number": "605-725-8754"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIMROSE SENIOR HOLDINGS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-01",
        "last_updated": "2022-05-12",
        "certification_date": "2022-05-12",
        "status": "A",
        "authorized_official_last_name": "DUTENHOFFER",
        "authorized_official_first_name": "BECKY",
        "authorized_official_title_or_position": "OPERATIONS SPECIALIST",
        "authorized_official_telephone_number": "605-725-3859"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "385H00000X",
            "taxonomy_group": "",
            "desc": "Respite Care",
            "state": "AK",
            "license": "100747",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "RL0010",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Primrose Retirement Community of Wasilla",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Primrose Retirement Community of Wasilla",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Justin Elliot Profitt, PHARM. D
• Joanne Denise Pross, RN

• Assisted Living Facility in Wasilla, AK
• Providers in Wasilla, AK by specialty
• Assisted Living Facility in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.