# YUKON-KUSKOKWIM HEALTH CORPORATION

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

## Provider details

- **NPI number:** 1346585056
- **Authorized official:** SHANE CARLLSON RN (RN)
- **Authorized official phone:** (907) 543-6106

## Contact information

- **Practice address:** 528 CHEIF EDDIE HOFFMEN, YUKON-KUSKOKWIM HEALTH CORPORATION, BETHEL, AK 99559-0528
- **Practice address phone:** (907) 546-6106
- **Practice address fax:** (907) 543-6159
- **Mailing address:** PO BOX 528, YUKON-KUSKOKWIM HEALTH CORPORATION, BETHEL, AK 99559-0528
- **Mailing address phone:** (907) 546-6106
- **Mailing address fax:** (907) 543-6159

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM0850X | Adult Mental Health Clinic/Center | NUR R 27765 | AK | — |
| 261QM0855X | Adolescent and Children Mental Health Clinic/Center | NUR R 27765 | AK | Yes |

## Other

- **Enumeration date:** 12/06/2012
- **Last updated:** 12/06/2012