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BIG LAKE COUNTRY CLUB, LLC
NPI 1639497415
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities in Houston, AK

Active since May 04, 2010
12528 HAWK LANE, HOUSTON, AK 99694(907) 892-6944 Get Directions Write a Review

NPPES record last updated: July 5, 2023. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Big Lake Country Club, Llc NPPES

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

BIG LAKE COUNTRY CLUB, LLC (NPI 1639497415) 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 May 2010. The organization lists Lynda Plettner, President / Administrator, as its authorized official.

NPPES Registry Identity

NPI1639497415
Entity TypeOrganization
Primary Taxonomy320900000X
Legal Business NameBIG LAKE COUNTRY CLUB, LLC
Location Address12528 HAWK LANEHouston, AK 99694
Mailing AddressPo Box 299136Wasilla, AK 99629 · (907) 892-6944
Phone(907) 892-6944
Organization SubpartNo
Authorized OfficialLynda PlettnerPresident / Administrator · (907) 892-6944
Enumeration DateMay 4, 2010
Last NPPES UpdateJuly 5, 2023
NPPES CertifiedJuly 5, 2023
✔ NPI 1639497415 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyCommunity Based Residential Treatment Facility, Intellectual and/or Developmental DisabilitiesResidential Treatment Facilities
Taxonomy Code320900000X
License✔ Licensed in AK · 940288
Definition
A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities.
Also ListedCase ManagementTaxonomy 251B00000X · License CMG (AK)
Also ListedCommunity/Behavioral HealthTaxonomy 251S00000X · License HCS (AK)
12528 HAWK LANE, Houston, AK 99694
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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
BIG LAKE COUNTRY CLUB
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 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, LLC's NPI number?

The NPI number for Big Lake Country Club, LLC is 1639497415. It was assigned to this organization in the NPPES registry on May 4, 2010.

Where is Big Lake Country Club, LLC located?

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

What is Big Lake Country Club, LLC'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, LLC was last updated on July 5, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.