# CHUGACHMIUT

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Anesia Anahonak Moonin Clinic
- **Organization subpart:** No

## Provider details

- **NPI number:** 1902077837
- **Authorized official:** KELLEY BAKER (HEALTH SERVICES DIVISION DIRECTOR)
- **Authorized official phone:** (907) 334-0148

## Contact information

- **Practice address:** 63998 GRAHAM ROAD UNIT \#3, PORT GRAHAM, AK 99603
- **Practice address phone:** (907) 284-2241
- **Practice address fax:** (907) 284-2277
- **Mailing address:** 1840 BRAGAW ST STE 110, ANCHORAGE, AK 99508-3463
- **Mailing address phone:** (907) 562-4155

## Taxonomy

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

## Other

- **Enumeration date:** 03/19/2008
- **Last updated:** 12/13/2021