NPIMap

Organization Active NPI

Kenai Peninsula Community Care Center

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Kenai, AK
National Provider Identifier
1952440570
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X
License
311415 Issued in AK
Legal business name
KENAI PENINSULA COMMUNITY CARE CENTER
Practice address
320 S Spruce St
Kenai, AK 99611-7939
Phone
(907) 283-7635
Fax
(907) 283-9575
NPI assigned
Feb 6, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Miss Tamara J. Bidwell
Title
Executive Director
Phone
(907) 283-7635

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emotionally Disturbed Childrens' Residential Treatment Facility 322D00000X 311415 AK Primary

Addresses

Primary practice location

320 S Spruce St
Kenai, AK 99611-7939

Mailing address

320 S Spruce St
Kenai, AK 99611-7939
Phone (907) 283-7635

National Provider Directory

National Provider Directory
Tax ID family
Kenai Peninsula Community Care Center3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

NPI Registry JSON

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

{
    "created_epoch": "1170720000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1952440570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 S SPRUCE ST",
            "city": "KENAI",
            "state": "AK",
            "postal_code": "996117939",
            "telephone_number": "907-283-7635",
            "fax_number": "907-283-9575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 S SPRUCE ST",
            "city": "KENAI",
            "state": "AK",
            "postal_code": "996117939",
            "telephone_number": "907-283-7635",
            "fax_number": "907-283-9575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENAI PENINSULA COMMUNITY CARE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-06",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BIDWELL",
        "authorized_official_first_name": "TAMARA",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "907-283-7635",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "AK",
            "license": "311415",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kenai, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.