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Organization

MANIILAQ ASSOCIATION

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. IAN ERLICH PRESIDENT/CEO (PRESIDENT/CEO)
(907) 442-7634
Entity
Organization

Contact information

Practice address
607 WOLVERINE DRIVE, KOTZEBUE, AK 99752-1073
(907) 442-7919
Mailing address
PO BOX 1073, KOTZEBUE, AK 99752-1073
(907) 442-7917

Taxonomy

Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
234051
AK

Other

Enumeration date
12/23/2010
Last updated
12/23/2010
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