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BIG LAKE COUNTRY CLUB, LLC
NPI 1700563301
Residential Treatment Facility, Intellectual and/or Developmental Disabilities in Houston, AK

Active since July 05, 2023
12528 W. HAWK LANE, HOUSTON, AK 99694(907) 232-8466 Get Directions Write a Review

NPPES record last updated: July 5, 2023. Verified against the NPPES registry weekly; last sync: August 02, 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 1700563301) is a healthcare organization registered as a residential treatment facility, intellectual and/or developmental disabilities in Houston, Alaska and active in the NPI registry since July 2023. The organization lists Stephen Phillip Geddes, Manager, as its authorized official.

NPPES Registry Identity

NPI1700563301
Entity TypeOrganization
Primary Taxonomy320600000X
Legal Business NameBIG LAKE COUNTRY CLUB, LLC
Location Address12528 W. HAWK LANEHouston, AK 99694
Mailing AddressPo Box 520069Big Lake, AK 99652-0069 · (907) 232-8466
Phone(907) 232-8466
Organization SubpartYesParent: Big Lake Country Club Llc
Authorized OfficialStephen Phillip GeddesManager · (907) 250-6605
Enumeration DateJuly 5, 2023
NPPES CertifiedJune 26, 2023
✔ NPI 1700563301 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyResidential Treatment Facility, Intellectual and/or Developmental DisabilitiesResidential Treatment Facilities
Taxonomy Code320600000X
Definition
A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental and intellectual disabilities and are not able to live independently.
12528 W. HAWK LANE, Houston, AK 99694
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Other Names 1

Other NameBig Lake Country Club I

Other Providers at the Same Location NPPES

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

BIG LAKE COUNTRY CLUB, LLC
Residential Treatment Facility, Intellectual and/or Developmental Disabilities
12528 W. HAWK LANE
HOUSTON, AK 99694
Matanuska-Susitna Borough (907) 232-8466

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 1700563301. It was assigned to this organization in the NPPES registry on July 5, 2023. The provider is also known as Big Lake Country Club I.

Where is Big Lake Country Club, LLC located?

Big Lake Country Club, LLC is located at 12528 W. Hawk Lane, Houston, AK 99694. The listed phone number is (907) 232-8466.

What is Big Lake Country Club, LLC's specialty?

The primary specialty registered for this NPI is Residential Treatment Facility, Intellectual and/or Developmental Disabilities with taxonomy code 320600000X.

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.