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BIG LAKE COUNTRY CLUB
NPI 1154580835
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities in Houston, AK

Active since June 06, 2008
12528 HAWK LANE, HOUSTON, AK 99694(907) 892-6944 Get Directions Write a Review

NPPES record last updated: July 22, 2009. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Big Lake Country Club NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BIG LAKE COUNTRY CLUB (NPI 1154580835) is a healthcare organization registered as a community based residential treatment facility, intellectual and/or developmental disabilities in Houston, Alaska and active in the NPI registry since June 2008. The organization lists Jess G Adams, Staff Office, as its authorized official.

NPPES Registry Identity

NPI1154580835
Entity TypeOrganization
Primary Taxonomy320900000X
Legal Business NameBIG LAKE COUNTRY CLUB
Location Address12528 HAWK LANEHouston, AK 99694-2528
Mailing AddressPo Box 299136Wasilla, AK 99629-9136 · (907) 892-6944
Phone(907) 892-6944
Organization SubpartNo
Authorized OfficialJess G AdamsStaff Office · (907) 892-6944
Enumeration DateJune 6, 2008
Last NPPES UpdateJuly 22, 2009
✔ NPI 1154580835 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCommunity Based Residential Treatment Facility, Intellectual and/or Developmental DisabilitiesResidential Treatment Facilities
Taxonomy Code320900000X
License✔ Licensed in AK · 100554
Definition
A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities.
12528 HAWK LANE, Houston, AK 99694
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Other Identifiers 1

MedicaidHC78981AK

Other Providers at the Same Location NPPES 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

COZY ACRES LLC
Assisted Living Facility
12528 HAWK LANE
HOUSTON, AK 99694
Matanuska-Susitna Borough (907) 892-6944
LYNDA J PLETTNER
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
12528 HAWK LANE
HOUSTON, AK 99694
Matanuska-Susitna Borough (907) 892-6944
JODY HALL
Case Manager/Care Coordinator
12528 HAWK LANE
HOUSTON, AK 99694
Matanuska-Susitna Borough (907) 892-6944
MR. STEPHEN PHILLIP GEDDES
Case Manager/Care Coordinator
12528 HAWK LANE
HOUSTON, AK 99694
Matanuska-Susitna Borough (907) 892-6944
BIG LAKE COUNTRY CLUB, LLC
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
12528 HAWK LANE
HOUSTON, AK 99694
Matanuska-Susitna Borough (907) 892-6944
BIG LAKE MENTAL HEALTH SERVICES
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
12528 HAWK LANE
HOUSTON, AK 99694
Matanuska-Susitna Borough (907) 892-6946

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Big Lake Country Club's NPI number?

The NPI number for Big Lake Country Club is 1154580835. It was assigned to this organization in the NPPES registry on June 6, 2008.

Where is Big Lake Country Club located?

Big Lake Country Club is located at 12528 Hawk Lane, Houston, AK 99694. The listed phone number is (907) 892-6944.

What is Big Lake Country Club's specialty?

The primary specialty registered for this NPI is Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities with taxonomy code 320900000X.

When was this NPI record last updated?

The NPPES record for Big Lake Country Club was last updated on July 22, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.