Take Aim Independent Living Solutions, LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

SC60593114 Issued in WA

Legal business name

TAKE AIM INDEPENDENT LIVING SOLUTIONS, LLC

Practice address

5508 Poplar PL
Ferndale, WA 98248-8904

Phone

(360) 305-2251

NPI assigned

Mar 12, 2016

Organization subpart

No

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

Authorized official

Name

Mrs. Stacie Ann Owen, MSW

Title

Director

Phone

(350) 305-2251

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1457740800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1457740800000",
    "number": "1912368341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5508 POPLAR PL",
            "city": "FERNDALE",
            "state": "WA",
            "postal_code": "982488904",
            "telephone_number": "360-305-2251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5508 POPLAR PL",
            "city": "FERNDALE",
            "state": "WA",
            "postal_code": "982488904",
            "telephone_number": "360-305-2251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TAKE AIM INDEPENDENT LIVING SOLUTIONS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-12",
        "last_updated": "2016-03-12",
        "status": "A",
        "authorized_official_last_name": "OWEN",
        "authorized_official_first_name": "STACIE",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "350-305-2251",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MSW"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "WA",
            "license": "SC60593114",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stacey Speelman, LISW-S, LICSW
• Elizabeth Steensland, M.A. CF-SLP
• Fawn M Sterling-Collins
• Suzanne Elizabeth Stratford, OTR/L
• Karri J Street, LMP
• Norman Tang
• Sarah K Tevelde
• Total Renal Care Inc
• Jessica T Tragesser, ARNP
• Tam Thanh Tran, PHARMD

• Community/Behavioral Health Agency in Ferndale, WA
• Providers in Ferndale, WA by specialty
• Community/Behavioral Health Agency in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 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.