Big Lake Country Club, LLC

NPI #1639497415 in Houston, Alaska

Provider Information

NPI Number: 1639497415
Entity Type: Organization
Organization Name: Big Lake Country Club, LLC
Primary Specialty: Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Enumeration Date: May 4, 2010
Last Updated: Jul 5, 2023

Practice Location

Address: 12528 HAWK LANE
City: Houston
State: Alaska
ZIP Code: 99694
Phone: (907) 892-6944

Authorized Official

Name: MS. LYNDA PLETTNER
Title: PRESIDENT / ADMINISTRATOR
Phone: (907) 892-6944

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Case Management	251B00000X
Community/Behavioral Health	251S00000X
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities	320900000X	Primary

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