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MANIILAQ ASSOCIATION KSCCC NPI 1629109939


NPI Information

NPI: 1629109939
Provider Name: MANIILAQ ASSOCIATION KSCCC

Doing Business As: KOTZEBUE SENIOR CITIZENS CULTURAL CENTER

Classification: Assisted Living Facility - 310400000X
Entity Type: Organization
Address:
607 WOLVERINE DRIVE
KOTZEBUE, AK
ZIP 99752
Phone: (907) 442-7917
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MANIILAQ ASSOCIATION KSCCC is an assisted living facility in Kotzebue, AK. The provider is a facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. MANIILAQ ASSOCIATION KSCCC NPI is 1629109939. The provider is registered as an organization entity type.
The provider Is Doing Business As Kotzebue Senior Citizens Cultural Center.

The provider's business location address is:

607 WOLVERINE DRIVE
KOTZEBUE, AK
ZIP 99752-073
Phone: (907) 442-7917
Fax: (907) 442-7932

The provider's authorized official is Kellie B. Haas .
The authorized official title is Elder Services Director and has the following contact phone number (907) 442-7917.

The enumeration date for this NPI number is 3/8/2007 and was last updated on 8/22/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1310400000XAssisted Living Facility000063ALASKAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1CMG590MEDICAIDALASKA
2RL3590MEDICAIDALASKA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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