Provider Demographics
NPI:1093183279
Name:COZY ACRES LLC
Entity Type:Organization
Organization Name:COZY ACRES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT / ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:LYNDA
Authorized Official - Middle Name:
Authorized Official - Last Name:PLETTNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:907-892-6944
Mailing Address - Street 1:PO BOX 520069
Mailing Address - Street 2:
Mailing Address - City:BIG LAKE
Mailing Address - State:AK
Mailing Address - Zip Code:99652-0069
Mailing Address - Country:US
Mailing Address - Phone:907-892-6944
Mailing Address - Fax:907-892-6945
Practice Address - Street 1:12528 HAWK LANE
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:AK
Practice Address - Zip Code:99694
Practice Address - Country:US
Practice Address - Phone:907-892-6944
Practice Address - Fax:907-892-6945
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-04
Last Update Date:2015-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK1025659310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility