# MT SANFORD TRIBAL CONSORTIUM

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1083038640
- **Authorized official:** MRS. EVELYN BEETER (PRESIDENT/CEO)
- **Authorized official phone:** (907) 822-5399

## Contact information

- **Practice address:** 34 MILE TOK HIGHWAY, GAKONA, AK 99586-0357
- **Practice address phone:** (907) 822-5399
- **Mailing address:** PO BOX 357, CHISTOCHINA, AK 99586-0357
- **Mailing address phone:** (907) 822-5399

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251K00000X | Public Health or Welfare Agency | — | — | Yes |

## Other

- **Enumeration date:** 02/18/2014
- **Last updated:** 02/18/2014