# MANIILAQ

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

## Provider details

- **NPI number:** 1376991844
- **Authorized official:** RAYMOND COPPOCK (COUNSLOR)
- **Authorized official phone:** (907) 442-7649

## Contact information

- **Practice address:** 733 2ND AVE, KOTZEBUE, AK 99752-0256
- **Practice address phone:** (907) 442-7640
- **Practice address fax:** (907) 442-7749
- **Mailing address:** 733 2ND AVE, KOTZEBUE, AK 99752-0256

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 282E00000X | Long Term Care Hospital | — | NULL | Yes |

## Other

- **Enumeration date:** 05/25/2016
- **Last updated:** 05/25/2016