WASILLA RETIREMENT, LLC (NPI# 1467696641) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467696641 |
| Entity Type | Organization |
| Organization Name | WASILLA RETIREMENT, LLC |
| Other Organization Name | PRIMROSE RETIREMENT COMMUNITY OF WASILLA |
| Practice Address |
889 N. Elkhorn Drive Wasilla AK 99654 |
| Practice Telephone | 9073735500 |
| Practice Fax Number | 6057258754 |
| Mailing Telephone | 9073735500 |
| Mailing Fax Number | 6057258754 |
| Enumeration Date | 2009-05-01 |
| Last Update Date | 2009-12-15 |
| Authorized Official Name | MS. BONNIE JEAN KELLY (DIRECTOR OF NURSING) |
| Authorized Official Telephone | 6052263300 |
| Authorized Official Credential | REGISTERED NURSE |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 385H00000X | Respite Care | 100747 | AK | Respite Care Facility |
| Y | 310400000X | Assisted Living Facility | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AK | RL0010 | 05 |
| Other Name | Type Code |
|---|---|
| Primrose Retirement Community of Wasilla | Doing Business As Name - Organization |
| Street Address |
889 N. ELKHORN DRIVE |
| City | WASILLA |
| State | AK |
| Zip Code | 99654 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003426784 | Colleen Maggie Newcity | Case Manager/Care Coordinator | 851 Westpoint Suite 310, Wasilla, AK 99654 | 2020-08-06 |
| 1659995884 | Amy M Lowe | Peer Specialist | 1363 W Spuce Ave, Wasilla, AK 99654 | 2020-06-03 |
| 1922648690 | Achieve Medical Alaska LLC | Clinic/Center | 1981 E Palmer, Suite 230, Wasilla, AK 99654 | 2020-01-10 |
| 1588205538 | Juan Carlos Garcia | Physician Assistant | 950 East Bogard Road, Suite 103, Wasilla, AK 99654 | 2019-10-01 |
| 1427610864 | Sharon Webb | Counselor | 705 S Knik Goose Bay Rd Suite K, Wasilla, AK 99654 | 2019-07-06 |
| 1306401864 | Logan Lee Cook | Peer Specialist | 2953 E Fairview Loop, Wasilla, AK 99654 | 2019-05-09 |
| 1053883595 | Moose Creek Medical Clinic LLC | Nurse Practitioner | 2341 S. Fern St., Suite 300, Wasilla, AK 99654 | 2018-12-21 |
| 1487124962 | Melissa A Stevens | Massage Therapist | 2201 W That Rd, Wasilla, AK 99654 | 2018-11-28 |
| 1609359561 | Audrey E Beers | Midwife | 2405 S. Knik Goose Bay Rd., Wasilla, AK 99654 | 2018-09-07 |
| 1093297418 | Karlee Janine Mccorry | Occupational Therapist | 613 S Knik-goose Bay Rd, Wasilla, AK 99654 | 2018-09-01 |
| Find all providers in zip 99654 | ||||
| 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 |
|---|---|---|---|---|
| 1063050516 | Mary Ann Miller | Assisted Living Facility | 4519 W Amanda Dr, Wasilla, AK 99623-1046 | 2019-12-16 |
| 1659912152 | Kristal Steele | Assisted Living Facility | 2650 N Garnet Ln, Wasilla, AK 99654-3414 | 2019-10-05 |
| 1790262905 | Brendan Charles Mccann | Assisted Living Facility | 1460 E Mulchatna Dr, Wasilla, AK 99654-3540 | 2018-07-20 |
| 1477053965 | Justine M Fine | Assisted Living Facility | 1414 N Pioneer Peak Dr, Wasilla, AK 99654-5924 | 2018-02-20 |
| 1760996847 | Utopia LLC | Assisted Living Facility | 6651 N Grouse Loop, Wasilla, AK 99654-9020 | 2017-11-27 |
| 1659890879 | The Alaska Care Home | Assisted Living Facility | 5511 W Montclaire Ave, Wasilla, AK 99623-0984 | 2017-09-19 |
| 1164960183 | All Good Homes | Assisted Living Facility | 3551 N Aoki Dr, Wasilla, AK 99654-2835 | 2017-02-09 |
| 1093264814 | Joshua House, LLC. | Assisted Living Facility | 2180 S Foothills Blvd, Wasilla, AK 99623-9509 | 2016-09-22 |
| 1275902652 | Magnolia Manor LLC | Assisted Living Facility | 751 N Someret Cir, Wasilla, AK 99654 | 2015-09-16 |
| 1215374749 | Granny's Downhome Care Center | Assisted Living Facility | 2200 E Wolverine Cir, Wasilla, AK 99654-2708 | 2013-05-23 |
| Find all providers in WASILLA | ||||
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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.