Healthcare Provider Details

I. General information

NPI: 1609799444
Provider Name (Legal Business Name): KACHEMAK HOUSE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/30/2026
Last Update Date: 07/30/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

139 SKYLINE DRIVE
HOMER AK
99603
US

IV. Provider business mailing address

PO BOX 579
HOMER AK
99603-0579
US

V. Phone/Fax

Practice location:
  • Phone: 907-795-9050
  • Fax:
Mailing address:
  • Phone: 907-795-9050
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State

VIII. Authorized Official

Name: ABIGAIL O'CONNOR
Title or Position: MANAGER, MEMBER
Credential:
Phone: 907-795-9050