| Bristol Bay Counseling Center Ekwok Clinic | |
|
125 Airport Way Ekwok AK 99580 | |
| (907) 842-1230 | |
| (907) 842-5174 |
| Full Name | Bristol Bay Counseling Center Ekwok Clinic |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 125 Airport Way, Ekwok, Alaska |
| Authorized Official Name and Position | Cathy Leeann Taylor (PROVIDER ENROLLMENT SPECIALIST) |
| Authorized Official Contact | 9078425201 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bristol Bay Counseling Center Ekwok Clinic Po Box 130 Dillingham AK 99576-0130 Ph: (907) 842-5201 | Bristol Bay Counseling Center Ekwok Clinic 125 Airport Way Ekwok AK 99580 Ph: (907) 842-1230 |
| NPI Number | 1114509338 |
|---|---|
| Provider Enumeration Date | 04/27/2021 |
| Last Update Date | 04/29/2021 |
| Certification Date | 04/29/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114509338 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
Bristol Bay Area Health Corporation Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 70 Main Street, Ekwok, AK 99580 Phone: 907-842-1230 Fax: 907-842-5174 |