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MANIILAQ ASSOCIATION NPI 1679799977


NPI Information

NPI: 1679799977
Provider Name: MANIILAQ ASSOCIATION

Doing Business As: MANIILAQ RECOVERY CENTER

Classification: Counselor - 101Y00000X
Entity Type: Organization
Address:
435 SECOND STREET TED STEVENS WAY
KOTZEBUE, AK
ZIP 99752
Phone: (907) 442-7648
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MANIILAQ ASSOCIATION is a counselor in Kotzebue, AK. The provider is a provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification. MANIILAQ ASSOCIATION NPI is 1679799977. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Maniilaq Recovery Center.

The provider's business location address is:

435 SECOND STREET TED STEVENS WAY
KOTZEBUE, AK
ZIP 99752-256
Phone: (907) 442-7648
Fax: (907) 442-7821

The provider's authorized official is Sherry Ann Kulukhon .
The authorized official title is Treatment Services Supervisor and has the following contact phone number (907) 442-7648.

The enumeration date for this NPI number is 4/17/2007 and was last updated on 12/22/2008.


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
1101Y00000XCounselor3059ALASKAYes

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
1MHO 212MEDICAIDALASKA

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: 11/14/2023

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