LILLEY LODGE 1, LLC (NPI# 1013237635) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013237635 |
| Entity Type | Organization |
| Organization Name | LILLEY LODGE 1, LLC |
| Practice Address |
2330 Old Richardson Hwy North Pole AK 99705-6017 |
| Mailing Address |
Po Box 56709 North Pole AK 99705-1709 |
| Practice Telephone | 9073471489 |
| Practice Fax Number | 9074900322 |
| Mailing Telephone | 9073471489 |
| Mailing Fax Number | 9074900322 |
| Enumeration Date | 2010-06-04 |
| Last Update Date | 2010-06-04 |
| Authorized Official Name | MS. TERRYANN GAINER (ADMINISTRATOR OWNER) |
| Authorized Official Telephone | 9073471489 |
| Authorized Official Credential | MBA |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 310400000X | Assisted Living Facility | 100797 | AK | Nursing & Custodial Care Facilities |
| Street Address |
2330 OLD RICHARDSON HWY |
| City | NORTH POLE |
| State | AK |
| Zip Code | 99705-6017 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205238060 | Aurora Medical Transportation LLC | Private Vehicle | 2330 Old Richardson Hwy, North Pole, AK 99705-6017 | 2014-09-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225508815 | Madison Grove | Behavioral Analyst | 203 S. Santa Claus Lane, North Pole, AK 99705 | 2018-11-27 |
| 1104393123 | Jessica Marie Childress | Behavioral Analyst | 203 Santa Clause, North Pole, AK 99705 | 2018-10-29 |
| 1346722279 | Kimberly Shriner | Student in an Organized Health Care Education/Training Program | 1970 Hollowell Rd, North Pole, AK 99705 | 2018-09-06 |
| 1780108993 | Tracy Norris | Behavior Technician | 1000 Borda St., North Pole, AK 99705 | 2017-07-29 |
| 1912134420 | Donald Jermome Kosatka | Psychiatry & Neurology | Building 4066 602nd Street, Bassett Army Community Hospital, Fort Wainwright, AK 99705 | 2009-06-11 |
| 1174796247 | Monique Dase Smith | Psychiatry & Neurology | 1650 Cowles St., Fairbanks, AK 99705 | 2008-04-09 |
| 1376742494 | Vicki Elaine Readnour | Physical Therapist | 167-b Santa Claus Lane, North Pole, AK 99705 | 2007-07-18 |
| 1114091527 | Helyn M Lefgren | Family Medicine | 145 Santa Claus Lane, North Pole, AK 99705 | 2006-11-17 |
| 1174695803 | Eric P Buetow | Dentist | 2933 Horseshoe Way, North Pole, AK 99705 | 2006-11-15 |
| 1770578296 | North Pole Prescription Laboratory Inc | Pharmacy | 167 Santa Claus Lane, North Pole, AK 99705 | 2005-09-12 |
| Find all providers in zip 99705 | ||||
| Taxonomy Code | 310400000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Assisted Living Facility |
| A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437379542 | Lane Co Arctic Hearth Assisted Living Inc | Assisted Living Facility | 118 E 5th Ave, North Pole, AK 99705-7775 | 2007-04-30 |
| 1710106349 | Lane Co Arctic Hearth Assisted Living Inc | Assisted Living Facility | 109 E 5th Ave, North Pole, AK 99705-7774 | 2007-04-24 |
| 1780935031 | Eagles Wings LLC | Assisted Living Facility | 109 E 5th Ave, North Pole, AK 99705-7774 | 2012-09-26 |
| 1427259423 | Forget-me-not Senior Care Homes | Assisted Living Facility | 109 E 5th Ave, North Pole, AK 99705-7774 | 2007-05-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578164042 | Liveable Soulutions | Assisted Living Facility | 1504 W 47th Ave Unit B, Anchorage, AK 99503-6924 | 2020-11-02 |
| 1699372656 | Kathleen Corleto | Assisted Living Facility | 3180 Amanda Gayle Cir, Anchorage, AK 99507-2602 | 2020-10-02 |
| 1336754969 | Snow City Assisted Living Home, LLC | Assisted Living Facility | 2634 Carroll Pl Unit B, Anchorage, AK 99508-3821 | 2020-09-10 |
| 1750991733 | Uba Alh | Assisted Living Facility | 6730 E 10th Ave, Anchorage, AK 99504-1814 | 2020-08-05 |
| 1184233116 | Mckinley Care LLC | Assisted Living Facility | 337 E 4th Ave Unit B, Anchorage, AK 99501-2664 | 2020-07-27 |
| 1154949949 | Patrick L Sullivan | Assisted Living Facility | 3314 Dickson Rd, Anchorage, AK 99504-4035 | 2020-07-08 |
| 1699392035 | Open Arms Assisted Living West LLC | Assisted Living Facility | 3660 W 78th Ave, Anchorage, AK 99502-4471 | 2020-07-01 |
| 1760004998 | Guardian Angel | Assisted Living Facility | 8403 Mentra St, Anchorage, AK 99518-2906 | 2020-05-11 |
| 1609400738 | Courtney Morrison | Assisted Living Facility | 119 Scow Bay Lp Rd, Petersburg, AK 99833-1556 | 2020-02-27 |
| 1235761230 | Golden Years LLC | Assisted Living Facility | 2941 Morgan Loop, Anchorage, AK 99516 | 2020-02-07 |
| Find all providers with the same taxonomy | ||||
| City | NORTH POLE |
| Zip Code | 99705 |
Please comment or provide details below to improve the information on LILLEY LODGE 1, LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.