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Organization
BIG LAKE COUNTRY CLUB, LLC
Active
Organization
BIG LAKE COUNTRY CLUB, LLC
Active
Parent organization
BIG LAKE COUNTRY CLUB, LLC
Other names
Big Lake Country Club VI
Organization subpart
Yes
Provider details
NPI number
Legal business name
BIG LAKE COUNTRY CLUB, LLC
Authorized official
STEPHEN PHILLIP GEDDES (MANAGER)
(907) 250-6605
Entity
Organization
Contact information
Practice address
471 S. KENLAR ROAD, HOUSTON, AK 99694
(907) 232-8466
Mailing address
PO BOX 520069, BIG LAKE, AK 99652-0069
(907) 232-8466
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
NULL
Other
Enumeration date
07/05/2023
Last updated
07/05/2023
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