KENAI PENINSULA COMMUNITY CARE EMERGENCY (NPI# 1689015794) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689015794 |
| Entity Type | Organization |
| Organization Name | KENAI PENINSULA COMMUNITY CARE EMERGENCY |
| Practice Address |
320 S Spruce St Kenai AK 99611-7939 |
| Practice Telephone | 9072837635 |
| Practice Fax Number | 9072839575 |
| Mailing Telephone | 9072837635 |
| Mailing Fax Number | 9072839575 |
| Enumeration Date | 2013-07-17 |
| Last Update Date | 2013-07-17 |
| Authorized Official Name | MISS TAMARA BIDWELL (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 9072837635 |
| Authorized Official Credential | BA IN PSYCHOLOGY |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 322D00000X | Residential Treatment Facility, Emotionally Disturbed Children | AK | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AK | MH6326 | 05 |
| Street Address |
320 S SPRUCE ST |
| City | KENAI |
| State | AK |
| Zip Code | 99611-7939 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952440570 | Kenai Peninsula Community Care Center | Residential Treatment Facility, Emotionally Disturbed Children | 320 S Spruce St, Kenai, AK 99611-7939 | 2007-02-06 |
| 1528621356 | Caitlin Peterson | Counselor | 320 S Spruce St, Kenai, AK 99611-7939 | 2019-04-17 |
| 1972945889 | Kenai Peninsula Community Care So | Residential Treatment Facility, Emotionally Disturbed Children | 320 S Spruce St, Kenai, AK 99611-7939 | 2013-07-19 |
| 1972775617 | Terrya Elder | Social Worker | 320 S Spruce St, Kenai, AK 99611-7939 | 2008-04-01 |
| 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 | 322D00000X |
| Grouping | Residential Treatment Facilities |
| Classification | Residential Treatment Facility, Emotionally Disturbed Children |
| A provider facility or distinct part of the organization which renders an interdisciplinary program of mental health treatment to individuals under 21 years of age who have persistent dysfunction in major life areas. The dysfunction is of an extent and pervasiveness that requires a protected and highly structured therapeutic environment. These organizations, or distinct part of organizations, exclude those that provide acute psychiatric care, partial hospitalization, group living, therapeutic schooling, primary diagnosis substance abuse disorder treatment, or primary diagnosis mental retardation or developmental disability treatment. |
| Notes: Source: U.S. Department of Defense Regulation 6010.8-R, Chapter 6. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952440570 | Kenai Peninsula Community Care Center | Residential Treatment Facility, Emotionally Disturbed Children | 320 S Spruce St, Kenai, AK 99611-7939 | 2007-02-06 |
| 1972945889 | Kenai Peninsula Community Care So | Residential Treatment Facility, Emotionally Disturbed Children | 320 S Spruce St, Kenai, AK 99611-7939 | 2013-07-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982228177 | Juneau Youth Services, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 8460 Rainbow Row, Juneau, AK 99801-9041 | 2020-06-03 |
| 1447874631 | Juneau Youth Services, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 10815 Black Bear Rd, Juneau, AK 99801-8783 | 2020-06-03 |
| 1043834245 | Juneau Youth Services, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 10685 Mendenhall Loop Rd, Juneau, AK 99801 | 2020-06-03 |
| 1295359511 | Juneau Youth Services, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 10801 Black Bear Rd, Juneau, AK 99801 | 2020-06-02 |
| 1700400033 | Juneau Youth Services, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 10685 Mendenhall Lp Rd, Juneau, AK 99801 | 2020-06-02 |
| 1417502998 | Christopher Robert Jackson | Residential Treatment Facility, Emotionally Disturbed Children | 1502 Liatris Ln, North Pole, AK 99705-5082 | 2019-08-01 |
| 1326396821 | Presbyterian Hospitality House | Residential Treatment Facility, Emotionally Disturbed Children | 2771 E Hiawatha Dr, Wasilla, AK 99654-2853 | 2012-08-15 |
| 1598013096 | Presbyterian Hospitality House | Residential Treatment Facility, Emotionally Disturbed Children | 1145 W Granville St, Palmer, AK 99645-7118 | 2012-08-15 |
| 1639425812 | Presbyterian Hospitality House | Residential Treatment Facility, Emotionally Disturbed Children | 6969 S Hood Ct, Wasilla, AK 99624 | 2012-07-25 |
| 1457528366 | Boys and Girls Home of Alaska | Residential Treatment Facility, Emotionally Disturbed Children | 3101 Lathrop Street, Fairbanks, AK 99707-0870 | 2008-05-09 |
| 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.