SOUTH PENINSULA BEHAVIORAL HEALTH SVCS INC (NPI# 1124244660) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1124244660 |
Entity Type | Organization |
Organization Name | SOUTH PENINSULA BEHAVIORAL HEALTH SVCS INC |
Practice Address |
3948 Ben Walters Ln Homer AK 99603-7708 |
Practice Telephone | 9072357701 |
Practice Fax Number | 9072359147 |
Mailing Telephone | 9072357701 |
Mailing Fax Number | 9072359147 |
Enumeration Date | 2007-04-17 |
Last Update Date | 2020-08-22 |
Authorized Official Name | NINA ALLEN (CHIEF EXECUTIVE OFFICER) |
Authorized Official Telephone | 9072357701 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 385H00000X | Respite Care | Respite Care Facility |
Street Address |
3948 BEN WALTERS LN |
City | HOMER |
State | AK |
Zip Code | 99603-7708 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1285640961 | South Peninsula Behavioral Health Services Inc | Community/Behavioral Health | 3948 Ben Walters Ln, Homer, AK 99603-7708 | 2006-08-01 |
1235730029 | Margaret Mitchell | Case Manager/Care Coordinator | 3948 Ben Walters Ln, Homer, AK 99603-7708 | 2020-11-06 |
1619578440 | Cody Davidson | Counselor | 3948 Ben Walters Ln, Homer, AK 99603-7708 | 2020-11-06 |
1104427913 | Holly Bliss | Counselor | 3948 Ben Walters Ln, Homer, AK 99603-7708 | 2020-11-06 |
1578164398 | Russell Campbell | Counselor | 3948 Ben Walters Ln, Homer, AK 99603-7708 | 2020-11-06 |
1003417825 | Nathan Chorman | Counselor | 3948 Ben Walters Ln, Homer, AK 99603-7708 | 2020-11-06 |
1992306724 | Sharron Cotogno | Counselor | 3948 Ben Walters Ln, Homer, AK 99603-7708 | 2020-11-06 |
1144821976 | Brian Duffy | Counselor | 3948 Ben Walters Ln, Homer, AK 99603-7708 | 2020-11-06 |
1770184509 | Richard Everett | Counselor | 3948 Ben Walters Ln, Homer, AK 99603-7708 | 2020-11-06 |
1528669314 | James Fisher | Case Manager/Care Coordinator | 3948 Ben Walters Ln, Homer, AK 99603-7708 | 2020-11-06 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1518572387 | Morgan Dwyer | Counselor | 51310 Timber Bay Ct, Homer, AK 99603 | 2020-09-09 |
1346859824 | John George Hetrick | Counselor | 51310 Timber Bay Ct., Homer, AK 99603 | 2020-07-30 |
1093352502 | Katieostrommd | Obstetrics & Gynecology | 205 W Fairview, Homer, AK 99603 | 2019-12-03 |
1023651965 | Melissa Elizabeth Malcolm | Physical Therapy Assistant | 4107 Hohe Ave, Homer, AK 99603 | 2019-10-23 |
1184143620 | Homer Birth and Wellness Center | Clinic/Center | 3902 Shelford Street, Homer, AK 99603 | 2017-09-15 |
1588913271 | Sharon Marie Gorman | Registered Nurse | 3959 Ben Walters, Homer, AK 99603 | 2012-09-10 |
1477802197 | Aldergrove Assisted Living | Community Based Residential Treatment Facility, Mental Illness | 41045 Denny Lane, Homer, AK 99603 | 2012-09-10 |
1194087551 | Stephen Michael Mueller | Pharmacist | 3858 Lake Street, Suite #5, Lakeside Mall, Homer, AK 99603 | 2012-06-12 |
1962778001 | Homer Dental Center Inc | Dentist | 4014 Lake St., Ste 210, Homer, AK 99603 | 2012-03-22 |
1346544368 | William R Easton | General Practice | 2495 Bayridge Rd, Homer, AK 99603 | 2011-01-05 |
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Taxonomy Code | 385H00000X |
Grouping | Respite Care Facility |
Classification | Respite Care |
Definition to come. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1952534489 | The Ark of Homer | Respite Care | 1136 Seabreeze Ct, Homer, AK 99603-7935 | 2009-09-01 |
1396913307 | Fernridge Tlc | Respite Care | 40811 Mclay Road, Homer, AK 99603 | 2008-02-12 |
1619156254 | Elder Options of Alaska | Respite Care | 60788 Bear Creek Dr, Homer, AK 99603-9461 | 2007-10-31 |
1528284056 | Homer Senior Citizens, Inc. | Respite Care | 3935 Svedlund St, Homer, AK 99603-7673 | 2007-04-17 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1225668718 | Turnagain Assisted Living LLC. | Respite Care | 3406 Seppala Dr Unit B, Anchorage, AK 99517-1143 | 2020-01-23 |
1518500297 | Lamin St Jammeh | Respite Care | 7924 Parkway Dr, Anchorage, AK 99504-2840 | 2019-10-24 |
1548744469 | Independence Lodge, LLC | Respite Care | 6941 Stanley Dr, Anchorage, AK 99518-2163 | 2018-09-17 |
1255769899 | A Loving Care PCa | Respite Care | 343 W Benson Blvd Ste 4, Anchorage, AK 99503-3950 | 2013-10-17 |
1619244548 | A Kodiak Welcome Bed and Breakfast | Respite Care | 3570 Sean Circle, Kodiak, AK 99615 | 2011-11-21 |
1528358207 | Divine Mercy II Alh, LLC | Respite Care | 417 E 11th Ave Apt 5, Anchorage, AK 99501-4560 | 2011-04-14 |
1659601409 | Northern Lighthouse Dba Northern Lighthouse Day Center | Respite Care | 136 E Redoubt Ave, Soldotna, AK 99669-8012 | 2009-12-29 |
1467696641 | Wasilla Retirement, LLC | Respite Care | 889 N. Elkhorn Drive, Wasilla, AK 99654 | 2009-05-01 |
1780855791 | Trinion Quality Care Services, Inc | Respite Care | 909 Delapp Road, Bethel, AK 99559 | 2008-03-18 |
1881865921 | Trinion Quality Care Services, Inc | Respite Care | 1375 E Parks Hwy, Ste D-4, Wasilla, AK 99654-8288 | 2008-03-17 |
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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.