# KENAI PENINSULA COMMUNITY CARE EMERGENCY

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

## Provider details

- **NPI number:** 1689015794
- **Authorized official:** MISS TAMARA BIDWELL BA IN PSYCHOLOGY (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (907) 283-7635

## Contact information

- **Practice address:** 320 S SPRUCE ST, KENAI, AK 99611-7939
- **Practice address phone:** (907) 283-7635
- **Practice address fax:** (907) 283-9575
- **Mailing address:** 320 S SPRUCE ST, KENAI, AK 99611-7939
- **Mailing address phone:** (907) 283-7635
- **Mailing address fax:** (907) 283-9575

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 322D00000X | Emotionally Disturbed Childrens' Residential Treatment Facility | — | AK | Yes |

## Other

- **Enumeration date:** 07/17/2013
- **Last updated:** 07/17/2013

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | MH6326 | — | AK |