| Kic Social Services | |
|
2960 Tongass Ave Fl 1 Ketchikan AK 99901-5742 | |
| (907) 228-4917 | |
| (907) 228-4920 |
| Full Name | Kic Social Services |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 2960 Tongass Ave Fl 1, Ketchikan, Alaska |
| Authorized Official Name and Position | Debbie Patton (GENERAL MANAGER) |
| Authorized Official Contact | 9072284926 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kic Social Services 2960 Tongass Ave Fl 1 Ketchikan AK 99901-5742 Ph: (907) 228-4917 | Kic Social Services 2960 Tongass Ave Fl 1 Ketchikan AK 99901-5742 Ph: (907) 228-4917 |
| NPI Number | 1073766317 |
|---|---|
| Provider Enumeration Date | 10/30/2008 |
| Last Update Date | 10/30/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073766317 | NPI | - | NPPES |
| DA2696 | Medicaid | AK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (Alaska) | Primary |
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