| Bristol Bay Counseling Center Koliganek Clinic | |
|
5060 Main Street Koliganek AK 99576 | |
| (907) 842-1230 | |
| (907) 842-9250 |
| Full Name | Bristol Bay Counseling Center Koliganek Clinic |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 5060 Main Street, Koliganek, 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 Koliganek Clinic Po Box 130 Dillingham AK 99576-0130 Ph: (907) 842-5201 | Bristol Bay Counseling Center Koliganek Clinic 5060 Main Street Koliganek AK 99576 Ph: (907) 842-1230 |
| NPI Number | 1689257636 |
|---|---|
| Provider Enumeration Date | 04/28/2021 |
| Last Update Date | 04/30/2021 |
| Certification Date | 04/30/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689257636 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |