| Tribal- Life House Community Health Center | |
|
11495 N Callison Street Sutton AK 99674 | |
| (907) 631-7665 | |
| Not Available |
| Full Name | Tribal- Life House Community Health Center |
|---|---|
| Speciality | Clinic/center - Community Health |
| Location | 11495 N Callison Street, Sutton, Alaska |
| Authorized Official Name and Position | Ronald Lee Olson (EXECUTIVE VICE PRESIDENT OF FINANCE) |
| Authorized Official Contact | 9077294939 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Tribal- Life House Community Health Center Po Box 35198 Seattle WA 98124-5198 Ph: () - | Tribal- Life House Community Health Center 11495 N Callison Street Sutton AK 99674 Ph: (907) 631-7665 |
| NPI Number | 1043632037 |
|---|---|
| Provider Enumeration Date | 01/10/2014 |
| Last Update Date | 08/30/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043632037 | NPI | - | NPPES |
| 1607931 | Medicaid | AK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QC1500X | Clinic/center - Community Health | 20467 (Alaska) | Primary |
Chickaloon Village Traditional Council Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 16166 North Glen Highway, Mile 61.5 Glen Highway, Sutton, AK 99674 Phone: 907-745-0704 Fax: 907-745-0708 |