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333 Church Street Wrangell AK 99929 | |
| (907) 874-2373 | |
| (907) 874-2576 |
| Full Name | |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 333 Church Street, Wrangell, Alaska |
| Authorized Official Name and Position | Daniel Harris (VP/CFO) |
| Authorized Official Contact | 9074634000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
3100 Channel Dr Ste 300 Juneau AK 99801-7837 Ph: (907) 463-4074 | 333 Church Street Wrangell AK 99929 Ph: (907) 874-2373 |
| NPI Number | 1134765290 |
|---|---|
| Provider Enumeration Date | 11/25/2019 |
| Last Update Date | 02/18/2021 |
| Certification Date | 02/18/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134765290 | NPI | - | NPPES |
| 1704809 | Medicaid | AK | |
| 70206 | Other | AK | STATE OF ALASKA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
Alaska Island Community Services Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 333 Church Street, Wrangell, AK 99929 Phone: 907-874-2373 Fax: 907-874-2576 |