# BIG LAKE COUNTRY CLUB, LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** BIG LAKE COUNTRY CLUB, LLC
- **Other names:** Big Lake Country Club VI
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1669150207
- **Legal business name:** BIG LAKE COUNTRY CLUB, LLC
- **Authorized official:** STEPHEN PHILLIP GEDDES (MANAGER)
- **Authorized official phone:** (907) 250-6605

## Contact information

- **Practice address:** 471 S. KENLAR ROAD, HOUSTON, AK 99694
- **Practice address phone:** (907) 232-8466
- **Mailing address:** PO BOX 520069, BIG LAKE, AK 99652-0069
- **Mailing address phone:** (907) 232-8466

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 320600000X | Intellectual and/or Developmental Disabilities Residential Treatment Facility | — | NULL | Yes |

## Other

- **Enumeration date:** 07/05/2023
- **Last updated:** 07/05/2023