# CHICKALOON NATIVE VILLLAGE

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Chickaloon Village Traditional Council
- **Organization subpart:** No

## Provider details

- **NPI number:** 1619267937
- **Authorized official:** MRS. AMANDA NICOLE CHRISTIANSEN (CLINIC MANAGER)
- **Authorized official phone:** (907) 745-0704

## Contact information

- **Practice address:** 16166 NORTH GLEN HIGHWAY, MILE 61.5 GLEN HIGHWAY, SUTTON, AK 99674-1105
- **Practice address phone:** (907) 745-0704
- **Practice address fax:** (907) 745-0708
- **Mailing address:** PO BOX 1105, CHICKALOON, AK 99674-1105
- **Mailing address phone:** (907) 745-0704
- **Mailing address fax:** (907) 745-0708

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QC1500X | Community Health Clinic/Center | — | AK | Yes |

## Other

- **Enumeration date:** 04/08/2011
- **Last updated:** 04/08/2011