Jac Enterprises, Inc.

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

101027 Issued in AK

Legal business name

JAC ENTERPRISES, INC.

Practice address

701 North Forest Dr
Kenai, AK 99611

Phone

(907) 335-2050

Fax

(907) 335-2051

NPI assigned

Feb 7, 2014

Organization subpart

No

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

Authorized official

Name

Ms. Colleen McNulty

Title

Administrator

Phone

(907) 335-2050

Specialties & licenses 1

Addresses

Other names 1

• Charis Place Assisted Living Doing business as

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

{
    "created_epoch": "1391731200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1391731200000",
    "number": "1477977684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 NORTH FOREST DR",
            "city": "KENAI",
            "state": "AK",
            "postal_code": "99611",
            "telephone_number": "907-335-2050",
            "fax_number": "907-335-2051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 NORTH FOREST DR",
            "city": "KENAI",
            "state": "AK",
            "postal_code": "99611",
            "telephone_number": "907-335-2050",
            "fax_number": "907-335-2051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAC ENTERPRISES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-02-07",
        "last_updated": "2014-02-07",
        "status": "A",
        "authorized_official_last_name": "MCNULTY",
        "authorized_official_first_name": "COLLEEN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "907-335-2050",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "AK",
            "license": "101027",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Charis Place Assisted Living",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Assisted Living Facility in Kenai, AK
• Providers in Kenai, 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 Feb 7, 2014; 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.