NPIMap

Organization Active NPI

Homer Senior Citizens, Inc.

  • Assisted Living Facility
  • Homer, AK
National Provider Identifier
1982828224
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
License
000053 Issued in AK
Legal business name
HOMER SENIOR CITIZENS, INC.
Practice address
3935 Svedlund St
Homer, AK 99603-7673
Phone
(907) 235-7655
Fax
(907) 235-3739
NPI assigned
Apr 11, 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
Mr. Fred L Lau
Title
Administrator
Phone
(907) 235-7655

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X 000053 AK Primary

Addresses

Primary practice location

3935 Svedlund St
Homer, AK 99603-7673

Mailing address

3935 Svedlund St
Homer, AK 99603-7673
Phone (907) 235-7655

Other identifiers 1

IdentifierTypeStateIssuer
RL7789MedicaidAK

Other names 1

  • Friendship Terrace Assisted Living Other name

National Provider Directory

National Provider Directory
Tax ID family
Friendship Terrace Assisted Living4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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": "1176249600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1982828224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3935 SVEDLUND ST",
            "city": "HOMER",
            "state": "AK",
            "postal_code": "996037673",
            "telephone_number": "907-235-7655",
            "fax_number": "907-235-3739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3935 SVEDLUND ST",
            "city": "HOMER",
            "state": "AK",
            "postal_code": "996037673",
            "telephone_number": "907-235-7655",
            "fax_number": "907-235-3739"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOMER SENIOR CITIZENS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-11",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LAU",
        "authorized_official_first_name": "FRED",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "907-235-7655",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "AK",
            "license": "000053",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "RL7789",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Friendship Terrace Assisted Living",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Homer, 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.