NPIMap

Organization Active NPI

Northern Lighthouse Dba Northern Lighthouse Day Center

  • Respite Care
  • Soldotna, AK
National Provider Identifier
1659601409
Registry record updated Dec 29, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Respite CareTaxonomy code 385H00000X
License
NONE ISSED BY STATE Issued in AK
Legal business name
NORTHERN LIGHTHOUSE DBA NORTHERN LIGHTHOUSE DAY CENTER
Practice address
136 E Redoubt Ave
Soldotna, AK 99669-8012
Phone
(907) 398-2939
NPI assigned
Dec 29, 2009
Last updated
Dec 29, 2009By the provider in NPPES
Organization subpart
Yes
Parent organization
NORTHERN LIGHTHOUSEAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 29, 2009

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

Authorized official

Name
Mary Jo MettlerNPI 1437638178
Title
Program Administrator
Phone
(907) 398-2939

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Respite Care 385H00000X NONE ISSED BY STATE AK Primary

Addresses

Primary practice location

136 E Redoubt Ave
Soldotna, AK 99669-8012

Mailing address

PO Box 609
Soldotna, AK 99669-0609

National Provider Directory

National Provider Directory
Tax ID family
Northern Lighthouse Dba Northern Lighthouse Day Center3 organizations share this tax ID, including this one
Part of
Northern Lighthouse Dba Northern Lighthouse Day Center

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

136 E Redoubt Ave
Soldotna, AK 99669
Phone (907) 398-2939

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": "1262044800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1262044800000",
    "number": "1659601409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 609",
            "city": "SOLDOTNA",
            "state": "AK",
            "postal_code": "996690609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "136 E REDOUBT AVE",
            "city": "SOLDOTNA",
            "state": "AK",
            "postal_code": "996698012",
            "telephone_number": "907-398-2939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHERN LIGHTHOUSE DBA NORTHERN LIGHTHOUSE DAY CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NORTHERN LIGHTHOUSE",
        "enumeration_date": "2009-12-29",
        "last_updated": "2009-12-29",
        "status": "A",
        "authorized_official_last_name": "METTLER",
        "authorized_official_first_name": "MARY JO",
        "authorized_official_title_or_position": "PROGRAM ADMINISTRATOR",
        "authorized_official_telephone_number": "907-398-2939"
    },
    "taxonomies": [
        {
            "code": "385H00000X",
            "taxonomy_group": "",
            "desc": "Respite Care",
            "state": "AK",
            "license": "NONE ISSED BY STATE",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Soldotna, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2009; 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.