FULL LIFE LLP (NPI# 1588296461) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588296461 |
| Entity Type | Organization |
| Organization Name | FULL LIFE LLP |
| Practice Address |
12309 Gara Dr Kodiak AK 99615-9317 |
| Practice Telephone | 9074872181 |
| Mailing Telephone | 9075395108 |
| Enumeration Date | 2020-02-07 |
| Last Update Date | 2020-02-07 |
| Authorized Official Name | MR. JUSTIN BRENT WOOD (PROGRAM ADMINISTRATOR) |
| Authorized Official Telephone | 9075395108 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 373H00000X | Day Training/Habilitation Specialist | Nursing Service Related Providers |
| Street Address |
12309 GARA DR |
| City | KODIAK |
| State | AK |
| Zip Code | 99615-9317 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144864232 | Linda Irene Dunlap | Spec/Tech, Pathology | 1915 E. Remanof Drive, Kodiak, AK 99615 | 2019-10-31 |
| 1639638190 | Stephanie Brenteson | Community Health Worker | 125 Airport Way, Akhiok, AK 99615 | 2019-03-14 |
| 1609351022 | Desiree Alexis Wheeler | Optometrist | 3450 E Rezanof Dr, Kodiak, AK 99615 | 2018-10-02 |
| 1417479072 | Elaine Loomis Olsen | Case Manager/Care Coordinator | 1111 Purtov St., Kodiak, AK 99615 | 2017-07-14 |
| 1750828414 | Mary Jean Francisco | Case Manager/Care Coordinator | 717 East Rezanof Drive, Kodiak, AK 99615 | 2017-01-19 |
| 1558818112 | Carolyn Hawes | Case Manager/Care Coordinator | 717 Rezanof Dr, Kodiak, AK 99615 | 2016-09-01 |
| 1285083683 | Amanda Wilson | Community Health Worker | 124 Akhiok Street, Akhiok, AK 99615 | 2016-06-07 |
| 1447612056 | Kailee Champion | Massage Therapist | 3449 Rezanof Drive East, Kodiak, AK 99615 | 2016-03-23 |
| 1376891069 | Krystyna Mcrobert | Technician, Other | Cape Sarichef Road Bldg N46, Rockmore King Clinic, Kodiak, AK 99615 | 2012-08-28 |
| 1164778619 | Mark Anthony Johnson | Pharmacist | 3449 Rezanof Drive, Kodiak, AK 99615 | 2012-08-01 |
| Find all providers in zip 99615 | ||||
| Taxonomy Code | 373H00000X |
| Grouping | Nursing Service Related Providers |
| Classification | Day Training/Habilitation Specialist |
| Individuals experienced or trained in working with developmentally disabled individuals who need assistance in acquiring and maintaining life skills that enable them to cope more effectively with the demands of independent living. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770108995 | Jayme Bonty | Day Training/Habilitation Specialist | 1401 S Seward Meridian Pkwy Ste A&b, Wasilla, AK 99654-8312 | 2020-06-12 |
| 1619596723 | Ceara Streisel | Day Training/Habilitation Specialist | 7521 Brayton Dr # Na, Anchorage, AK 99507-2667 | 2020-04-09 |
| 1861029530 | Sarah Wood | Day Training/Habilitation Specialist | 44661 Sterling Hwy Ste A, Soldotna, AK 99669-7900 | 2020-03-24 |
| 1497381180 | Eric Tyskiewicz | Day Training/Habilitation Specialist | 7521 Brayton Dr # Dra, Anchorage, AK 99507-2667 | 2020-03-13 |
| 1053942854 | Loth Sayavong | Day Training/Habilitation Specialist | 4121 Crannog St, Anchorage, AK 99502-5174 | 2020-01-30 |
| 1578109989 | Jennifer Leigh Morehouse | Day Training/Habilitation Specialist | 1401 S Seward Meridian Pkwy # Abc, Wasilla, AK 99654-8312 | 2019-11-20 |
| 1205471232 | Tamara Wallace | Day Training/Habilitation Specialist | 1401 S Seward Meridian Pkwy Ste Abc, Wasilla, AK 99654-8312 | 2019-11-13 |
| 1013488709 | Billie Jo Hansen | Day Training/Habilitation Specialist | 850 S Roberts St Ste 400, Wasilla, AK 99654-8206 | 2018-12-06 |
| 1336634757 | Blooming Hearts | Day Training/Habilitation Specialist | 201 Old Steese Hwy Ste 5, Fairbanks, AK 99701-3160 | 2018-06-27 |
| 1235623794 | Brian Justin Moses | Day Training/Habilitation Specialist | 841 Chief Eddie Hoffman Highway, Bethel, AK 99559 | 2018-06-19 |
| 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.