YUKON-KUSKOKWIM HEALTH CORPORATION (NPI# 1346585056) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1346585056 |
| Entity Type | Organization |
| Organization Name | YUKON-KUSKOKWIM HEALTH CORPORATION |
| Practice Address |
528 Cheif Eddie Hoffmen Yukon-kuskokwim Health Corporation Bethel AK 99559-0528 |
| Mailing Address |
Po Box 528 Yukon-kuskokwim Health Corporation Bethel AK 99559-0528 |
| Practice Telephone | 9075466106 |
| Practice Fax Number | 9075436159 |
| Mailing Telephone | 9075466106 |
| Mailing Fax Number | 9075436159 |
| Enumeration Date | 2012-12-06 |
| Last Update Date | 2012-12-06 |
| Authorized Official Name | SHANE CARLLSON (RN) |
| Authorized Official Telephone | 9075436106 |
| Authorized Official Credential | RN |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QM0850X |
Clinic/Center Specialization: Adult Mental Health |
NUR R 27765 | AK | Ambulatory Health Care Facilities |
| Y | 261QM0855X |
Clinic/Center Specialization: Adolescent and Children Mental Health |
NUR R 27765 | AK | Ambulatory Health Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821476599 | Yukon-kuskokwim Health Corporation | Clinic/Center | 1260 A Chief Eddie Hoffman Hwy, Bethel, AK 99559 | 2015-05-13 |
| 1821438342 | Yukon-kuskokwim Health Corporation | Skilled Nursing Facility | 1100 Chief Eddie Hoffman Hwy, Bethel, AK 99559 | 2013-06-28 |
| 1306299714 | Yukon-kuskokwim Health Corporation | Transportation Broker | 700 Chief Eddie Hoffman Hwy, Bethel, AK 99559 | 2016-07-20 |
| 1457565731 | Yukon-kuskokwim Health Corporation | Case Management | 829 Chief Eddie Hoffman Hwy, Bethel, AK 99559-0528 | 2007-05-09 |
| 1518170836 | Yukon-kuskokwim Health Corporation | Case Management | 829 Chief Eddie Hoffman Hwy, Bethel, AK 99559-0528 | 2007-05-07 |
| 1447477815 | Yukon-kuskokwim Health Corporation | Counselor | 700 Chief Eddie Hoffman Hwy, Bethel, AK 99559 | 2007-04-19 |
| 1467679936 | Yukon-kuskokwim Health Corporation | Counselor | 5016 Noel Polty Blvd., Bethel, AK 99559 | 2007-04-19 |
| 1689719825 | Yukon-kuskokwim Health Corporation | Pharmacy | 700 Chief Eddie Hoffman Hwy, Bethel, AK 99559-0827 | 2007-02-21 |
| 1063567691 | Yukon-kuskokwim Health Corporation | Clinic/Center | 700 Chief Eddie Hoffman Hwy, Bethel, AK 99559 | 2007-01-24 |
| Street Address |
528 CHEIF EDDIE HOFFMEN YUKON-KUSKOKWIM HEALTH CORPORATION |
| City | BETHEL |
| State | AK |
| Zip Code | 99559-0528 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194337519 | Michael P Nicolai | Case Manager/Care Coordinator | 829 Chief Eddie Hoffman Hey, Bethel, AK 99559 | 2020-08-18 |
| 1003438508 | Enc Physical Therapy LLC | Physical Therapist | 223 Blackberry Street, Unit A, Bethel, AK 99559 | 2020-05-07 |
| 1780229609 | Laline Knox | Massage Therapist | 107 Alex Hatley Ste 1, Bethel, AK 99559 | 2019-11-14 |
| 1659920502 | Ana Celina Sebastian | Counselor | 1380 Calista Dr, Bethel, AK 99559 | 2019-09-04 |
| 1639730484 | Jerri Linda Moran-gentle | Massage Therapist | 430 A 7th Ave, Bethel, AK 99559 | 2019-06-24 |
| 1528625381 | Jennifer Peeks | Social Worker | 631 4th Ave. & Main St., Bethel, AK 99559 | 2019-05-28 |
| 1710451190 | Mary Theresa Thibeault | Registered Nurse | Bethel Public Health Center, 1490 Eddie Hoffman Highway, Bethel, AK 99559 | 2019-01-18 |
| 1659846210 | Freda Lizann Jimmie | Counselor | 829 Eddie Hoffman Highway, Bethel, AK 99559 | 2018-10-10 |
| 1073093977 | Romeo Mullai | Counselor | 1630 Calista Drive, Bethel, AK 99559 | 2018-08-20 |
| 1235623794 | Brian Justin Moses | Day Training/Habilitation Specialist | 841 Chief Eddie Hoffman Highway, Bethel, AK 99559 | 2018-06-19 |
| Find all providers in zip 99559 | ||||
| Taxonomy Code | 261QM0855X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Adolescent and Children Mental Health |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in children and adolescents. Services may be provided to parents and family members of the patient in the form of conjoint, group, or individual therapy, and education and/or training. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134729387 | Volunteers of America Alaska, Clark Ms | Clinic/Center | 150 Bragaw St, Anchorage, AK 99508-1307 | 2020-10-27 |
| 1255938239 | Anchorage Community Mental Health Services, Inc | Clinic/Center | 4045 Lake Otis Pkwy Ste 101, Anchorage, AK 99508-5227 | 2020-10-03 |
| 1780221127 | Latouche Pediatrics, LLC | Clinic/Center | 3340 Providence Dr Ste 452, Anchorage, AK 99508-4628 | 2019-12-04 |
| 1518435734 | Hope Community Resources Inc | Clinic/Center | 540 W International Airport Rd, Anchorage, AK 99518-1105 | 2018-11-06 |
| 1891224879 | Wild Goose Counseling LLC | Clinic/Center | 198 W Marydale Ave, Soldotna, AK 99669-7501 | 2017-06-05 |
| 1356555809 | Youth Advocates of Sitka, Inc | Clinic/Center | 408 Oja Way, Sitka, AK 99835-7622 | 2007-05-10 |
| 1538281514 | Alaska Children's Services, Inc. | Clinic/Center | 1709 Bragaw St, Anchorage, AK 99508-3436 | 2007-04-03 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.