NPIMap

Organization Active NPI

Brendan McCann

Doing business as Home on Mulchatna

  • Intellectual and/or Developmental Disabilities Residential Treatment Facility
  • Wasilla, AK
National Provider Identifier
1609353614
Registry record updated Jul 23, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X
License
100393 Issued in AK
Legal business name
BRENDAN MCCANN
Doing business as
Home on Mulchatna
Practice address
1460 E Mulchatna Dr
Wasilla, AK 99654-3540
Phone
(907) 841-2448
NPI assigned
Jul 23, 2018
Last updated
Jul 23, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2018

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

Authorized official

Name
Brendan McCannNPI 1790262905
Title
Owner / Operator
Phone
(907) 841-2448

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X 100393 AK Primary

Addresses

Primary practice location

1460 E Mulchatna Dr
Wasilla, AK 99654-3540

Mailing address

1460 E Mulchatna Dr
Wasilla, AK 99654-3540
Phone (907) 841-2448

Other identifiers 1

IdentifierTypeStateIssuer
PENDINGMedicaidAK

Other names 1

  • Home on Mulchatna Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1532304000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1532304000000",
    "number": "1609353614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1460 E MULCHATNA DR",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996543540",
            "telephone_number": "907-841-2448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1460 E MULCHATNA DR",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996543540",
            "telephone_number": "907-841-2448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRENDAN MCCANN",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-23",
        "last_updated": "2018-07-23",
        "status": "A",
        "authorized_official_last_name": "MCCANN",
        "authorized_official_first_name": "BRENDAN",
        "authorized_official_title_or_position": "OWNER / OPERATOR",
        "authorized_official_telephone_number": "907-841-2448"
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "AK",
            "license": "100393",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Home on Mulchatna",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Wasilla, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 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.