Provider Demographics
NPI:1679038376
Name:FAR NORTH CARE, LLC
Entity Type:Organization
Organization Name:FAR NORTH CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MERI
Authorized Official - Middle Name:KAY
Authorized Official - Last Name:TEICH
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:907-414-8665
Mailing Address - Street 1:PO BOX 879390
Mailing Address - Street 2:
Mailing Address - City:WASILLA
Mailing Address - State:AK
Mailing Address - Zip Code:99687-9390
Mailing Address - Country:US
Mailing Address - Phone:907-414-8665
Mailing Address - Fax:
Practice Address - Street 1:651 E HEATHER WAY
Practice Address - Street 2:
Practice Address - City:WASILLA
Practice Address - State:AK
Practice Address - Zip Code:99654-1410
Practice Address - Country:US
Practice Address - Phone:907-357-0055
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-06
Last Update Date:2019-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3104A0625XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Mental Illness
No174200000XOther Service ProvidersMeals
No251E00000XAgenciesHome Health
No385H00000XRespite Care FacilityRespite Care