BONITA R QUALE (NPI# 1396878880) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396878880 |
| Entity Type | Individual |
| Full Name | BONITA R QUALE |
| Practice Address |
47710 Interlake Dr Kenai AK 99611-9694 |
| Practice Telephone | 9077768684 |
| Practice Fax Number | 9077768805 |
| Mailing Telephone | 9077768684 |
| Mailing Fax Number | 9077768805 |
| Enumeration Date | 2007-03-13 |
| Last Update Date | 2007-08-31 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 310400000X | Assisted Living Facility | 224 | AK | Nursing & Custodial Care Facilities |
| N | 310400000X | Assisted Living Facility | 100608 | AK | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AK | RL4771 | 05 | |
| AK | RL 3719 | 05 |
| Street Address |
47710 INTERLAKE DR |
| City | KENAI |
| State | AK |
| Zip Code | 99611-9694 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407293145 | Our House On The Lake LLC | Assisted Living Facility | 47710 Interlake Dr, Kenai, AK 99611-9694 | 2013-06-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649803099 | Guardian Flight LLC | Ambulance | 145 Granite Point Ct, Kenai, AK 99611 | 2020-02-13 |
| 1104482967 | James Daniel Hudson | Massage Therapist | 601 Frontage Rd Suite 103, Kenai, AK 99611 | 2019-05-16 |
| 1255996351 | Shelly Lynn Niblack | Counselor | 10200, Kenai Sour Hwy, Kenai, AK 99611 | 2019-05-03 |
| 1780142042 | Odyssey Family Practice LLC | Clinic/Center | 11595 Kenai Spur Highway, Kenai, AK 99611 | 2019-03-06 |
| 1043793656 | Jerri Ann Chivers | Massage Therapist | 10815 Kenai Spur Highway, Kenai, AK 99611 | 2018-09-10 |
| 1003320060 | Christine G. Morin | Massage Therapist | 1608 Tanga Circle, Kenai, AK 99611 | 2017-11-28 |
| 1013433259 | Amanda Mckinley | Registered Nurse | 630 Barnacle Way Suite A, Kenai, AK 99611 | 2017-08-18 |
| 1780132753 | Kenai Peninsula Imaging Center LLC | Clinic/Center | 100 Trading Bay Rd Ste 7, Kenai, AK 99611 | 2016-09-19 |
| 1376905000 | Savana Long | Licensed Practical Nurse | 1700 Cone Avenue, Kenai, AK 99611 | 2016-03-22 |
| 1477977684 | Jac Enterprises, Inc. | Assisted Living Facility | 701 North Forest Dr, Kenai, AK 99611 | 2014-02-07 |
| Find all providers in zip 99611 | ||||
| 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 |
|---|---|---|---|---|
| 1477977684 | Jac Enterprises, Inc. | Assisted Living Facility | 701 North Forest Dr, Kenai, AK 99611 | 2014-02-07 |
| 1114241544 | New River, Inc | Assisted Living Facility | 750 Baleen Ave, Suite 1, Kenai, AK 99611-8839 | 2010-03-13 |
| 1912188418 | Jennifer Tyler | Assisted Living Facility | 45864 Inlet Breeze St, Kenai, AK 99611-9679 | 2007-11-27 |
| 1225258619 | Nicholsons Assisted Living Inc | Assisted Living Facility | 36601 Navigator Street, Kenai, AK 99611-0000 | 2007-04-26 |
| 1407293145 | Our House On The Lake LLC | Assisted Living Facility | 47710 Interlake Dr, Kenai, AK 99611-9694 | 2013-06-03 |
| 1013265099 | Pathways LLC | Assisted Living Facility | 45864 Inlet Breeze St, Kenai, AK 99611 | 2012-08-21 |
| 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 | ||||
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| 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.