J&J Independent Living, LLC

Primary specialty

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

Legal business name

J&J INDEPENDENT LIVING, LLC

Practice address

165 E. Parks Hwy
Suite 106
Wasilla, AK 99654-3909

Phone

(907) 373-3953

Fax

(907) 373-3983

NPI assigned

Sep 14, 2014

Organization subpart

No

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

Authorized official

Name

Billie Jo Hansen

Title

Administrator/Owner

Phone

(907) 715-6507

Specialties & licenses 7

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1410652800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1474416000000",
    "number": "1639570203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "165 E PARKS HWY",
            "address_2": "SUITE 106",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996547059",
            "telephone_number": "907-373-3953",
            "fax_number": "907-373-3983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "165 E. PARKS HWY",
            "address_2": "SUITE 106",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996543909",
            "telephone_number": "907-373-3953",
            "fax_number": "907-373-3983"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "J&J INDEPENDENT LIVING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-14",
        "last_updated": "2016-09-21",
        "status": "A",
        "authorized_official_last_name": "HANSEN",
        "authorized_official_first_name": "BILLIE",
        "authorized_official_middle_name": "JO",
        "authorized_official_title_or_position": "ADMINISTRATOR/OWNER",
        "authorized_official_telephone_number": "907-715-6507"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "AK",
            "license": "1002558",
            "primary": false
        },
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": "AK",
            "license": "1002558",
            "primary": false
        },
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": "AK",
            "license": "1624210",
            "primary": false
        },
        {
            "code": "253J00000X",
            "taxonomy_group": "",
            "desc": "Foster Care Agency",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "AK",
            "license": null,
            "primary": false
        },
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "385H00000X",
            "taxonomy_group": "",
            "desc": "Respite Care",
            "state": "AK",
            "license": "1624210",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1624210",
            "state": "AK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1624208",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kari Lynn Ireland, LMT
• Tessa Irish
• Kelsea Irwin
• Bradley Duke Ischinger, PTA
• Jennifer L Ivory, CBIS
• Danielle Jabaay
• Nathan Jabaay
• Jessica J Jachimiec, MD
• Amber Hauoli Jackson, LMT
• Brendan Jackson

• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Wasilla, AK
• Providers in Wasilla, 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 Sep 21, 2016; 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.