# EMK INNOVATIVE HEALTH CARE CLINIC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** EMK INNOVATIVE HEALTH CARE CLINIC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1376368829
- **Legal business name:** EMK INNOVATIVE HEALTH CARE CLINIC
- **Authorized official:** DR. HENRIETTA EMOKIDI DNP, APRN (OWNER/PROVIDER)
- **Authorized official phone:** (907) 317-1703

## Contact information

- **Practice address:** 204 MULDOON RD, ANCHORAGE, AK 99504-1502
- **Practice address phone:** (907) 317-1703
- **Mailing address:** PO BOX 140665, ANCHORAGE, AK 99514-0665
- **Mailing address phone:** (907) 317-1703

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM0801X | Mental Health Clinic/Center (Including Community Mental Health Center) | — | NULL | — |
| 261QM0850X | Adult Mental Health Clinic/Center | — | NULL | — |
| 261QP2300X | Primary Care Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 11/20/2024
- **Last updated:** 11/20/2024