| Bristol Bay Counseling Center Manokotak Clinic | |
|
223 Second Street Manokotak AK 99628 | |
| (907) 842-1230 | |
| (907) 842-5174 |
| Full Name | Bristol Bay Counseling Center Manokotak Clinic |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 223 Second Street, Manokotak, 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 Manokotak Clinic Po Box 130 Dillingham AK 99576-0130 Ph: (907) 842-5201 | Bristol Bay Counseling Center Manokotak Clinic 223 Second Street Manokotak AK 99628 Ph: (907) 842-1230 |
| NPI Number | 1760064075 |
|---|---|
| Provider Enumeration Date | 04/26/2021 |
| Last Update Date | 04/30/2021 |
| Certification Date | 04/30/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760064075 | 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: 129 Main Street, Manokotak, AK 99628 Phone: 907-842-1230 Fax: 907-842-5174 |