# MANIILAQ ASSOCIATION

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Shungnak Health Clinic
- **Organization subpart:** No

## Provider details

- **NPI number:** 1255478806
- **Authorized official:** CHARLENE D TICKETT (CHP)
- **Authorized official phone:** (907) 437-2138

## Contact information

- **Practice address:** 32 BACK STREET, SHUNGNAK, AK 99773-0080
- **Practice address phone:** (907) 437-2138
- **Practice address fax:** (907) 437-2139
- **Mailing address:** 32 BACK STREET, SHUNGNAK, AK 99773-0080
- **Mailing address phone:** (907) 437-2138
- **Mailing address fax:** (907) 437-2139

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 302R00000X | Health Maintenance Organization | — | AK | Yes |

## Other

- **Enumeration date:** 01/31/2007
- **Last updated:** 08/22/2020