NORTHERN LIGHTHOUSE DAY CENTER NPI 1003035627

Respite Care in Anchorage, AK

NPI 1003035627 Organization Respite Care

About NORTHERN LIGHTHOUSE DAY CENTER

Northern Lighthouse Day Center is a provider established in Anchorage, Alaska specializing in respite care. The NPI number of Northern Lighthouse Day Center is 1003035627 and was assigned on April 2007. The practitioner's primary taxonomy code is 385H00000X with license number NONE ISSUED BY STATE (AK). The provider is registered as an organization and their NPI record was last updated one year ago. The authorized official of this NPI record is Mary Jo Mettler (Administrator)

NPI

1003035627

Provider NameNORTHERN LIGHTHOUSE DAY CENTER
Provider Location Address403 E 24TH AVE ANCHORAGE, AK 99503
Provider Mailing AddressPO BOX 241428 ANCHORAGE, AK 99524
NPI Entity TypeOrganization
Is Sole Proprietor?N/A
Is Organization Subpart?No
Enumeration Date04-24-2007
Last Update Date08-22-2020


Primary Taxonomy

Taxonomy Code385H00000X
ClassificationRespite Care
TypeRespite Care Facility
License No.NONE ISSUED BY STATE
License StateAK
Taxonomy DescriptionDefinition to come.

Business Address

NORTHERN LIGHTHOUSE DAY CENTER
403 E 24TH AVE
ANCHORAGE, AK
ZIP 99503
Phone: (907) 398-2939

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Mailing Address

NORTHERN LIGHTHOUSE DAY CENTER
PO BOX 241428
ANCHORAGE, AK
ZIP 99524
Phone:



Authorized Official

Authorized Official Name MARY JO METTLER
Authorized Official TitleADMINISTRATOR
Authorized Official Phone(907) 398-2939

Additional Identifiers


Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State
HC0349MEDICAID (05)AK

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.