LIFETOTHEFULLESTLLC (NPI# 1245774108) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245774108 |
| Entity Type | Organization |
| Organization Name | LIFETOTHEFULLESTLLC |
| Practice Address |
1233 5th Ave Fairbanks AK 99701-4211 |
| Practice Telephone | 9073171093 |
| Mailing Telephone | 9073171093 |
| Enumeration Date | 2016-12-12 |
| Last Update Date | 2016-12-12 |
| Authorized Official Name | MATTHEW JESELNIK (OWNER/ADMINISTRATOR) |
| Authorized Official Telephone | 9073171093 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3104A0625X |
Assisted Living Facility Specialization: Assisted Living, Mental Illness |
101139 | AK | Nursing & Custodial Care Facilities |
| Street Address |
1233 5TH AVE |
| City | FAIRBANKS |
| State | AK |
| Zip Code | 99701-4211 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386188720 | Matthew Jeselnik | Nursing Home Administrator | 1233 5th Ave, Fairbanks, AK 99701-4211 | 2016-12-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659984987 | Resource Center for Parents & Children, Inc. | Social Worker | 726 26th Ave, Suite #2, Fairbanks, AK 99701 | 2020-08-26 |
| 1134738982 | Aaron Paul Sarauer | Behavior Technician | 3121 Lathrop St., Fairbanks, AK 99701 | 2020-07-28 |
| 1437715505 | Fabienne Rose Marie Siddall | Case Manager/Care Coordinator | 122 1st Avenue, Fairbanks, AK 99701 | 2019-05-14 |
| 1902461957 | Jacqueline Marie Rahm | Counselor | Family Centered Services of Alaska - Rtc, 3101 Lathrop St., Fairbanks, AK 99701 | 2019-05-06 |
| 1821588989 | Corrie Wilson | Nurse Practitioner | 1025 Barnette Street, Fairbanks, AK 99701 | 2018-05-15 |
| 1922519305 | Sarishma Sangeeta Lal | Registered Nurse | 815 2nd Ave Ste 122, Fairbanks, AK 99701 | 2017-10-12 |
| 1245690569 | Christine L Simko | Naturopath | 1275 Sadler Way, Ste 100 Rm 147, Fairbanks, AK 99701 | 2016-02-29 |
| 1932581600 | Jennifer Davis | Registered Nurse | 1025 West Barnette St., Fairbanks, AK 99701 | 2015-06-18 |
| 1700272705 | John D. Zipperer Jr Md, LLC | Clinic/Center | 751 Old Richardson Hwy., Fairbanks, AK 99701 | 2015-04-07 |
| 1578957460 | Mara Justine Becker | Physician Assistant | 1717 W. Cowles St, Fairbanks, AK- ALASKA 99701 | 2015-03-27 |
| Find all providers in zip 99701 | ||||
| Taxonomy Code | 3104A0625X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Assisted Living Facility |
| Specialization | Assisted Living, Mental Illness |
| A facility providing supportive services to individuals who can function independently in most areas of activity, but need special guidance, assistance and/or monitoring as the result of a psychiatric problem. This type of facility requires a staff with special training in mental health training and dealing with psychiatric emergencies. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306130851 | Shining Star Assist Living | Assisted Living Facility | 2941 Westgate Pl, Fairbanks, AK 99709-4747 | 2011-06-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376169300 | Second Chance Support Services LLC | Assisted Living Facility | 741 Irwin St, Anchorage, AK 99508-1252 | 2020-06-25 |
| 1841815321 | Crisalyn Buenarte Ruiz | Assisted Living Facility | 3541 Corona Cir, Anchorage, AK 99517-1486 | 2020-06-10 |
| 1942858782 | My Home LLC | Assisted Living Facility | 6865 Viburnum Dr, Anchorage, AK 99507-2467 | 2019-08-26 |
| 1699320127 | Wasilla Group Home LLC | Assisted Living Facility | 3660 W Lynn Dr, Wasilla, AK 99654-0949 | 2019-08-01 |
| 1750935433 | Mind and Soul Assisted Living, LLC | Assisted Living Facility | 6124 E 12th Ave # D2, Anchorage, AK 99504-2355 | 2019-07-30 |
| 1689131989 | Tara Walker | Assisted Living Facility | 7774 Cherrywood Cir, Anchorage, AK 99507-2973 | 2019-02-23 |
| 1861966269 | Tina Renee Hopkins | Assisted Living Facility | 3471 W Wren St, Wasilla, AK 99623 | 2019-01-18 |
| 1902381940 | Alkamba Marenah Enterprises, LLC | Assisted Living Facility | 1545 Demeure Pl, Anchorage, AK 99508-3164 | 2018-09-25 |
| 1629585229 | Jessica Tiara Fulton | Assisted Living Facility | 1001 Cherry St Unit A, Anchorage, AK 99504-2230 | 2018-01-04 |
| 1881109767 | Michael Anthony Brown | Assisted Living Facility | 7940 Little Dipper Ave, Anchorage, AK 99504-4125 | 2017-12-13 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on LIFETOTHEFULLESTLLC.
| 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.