Organization
KIMMIE C SMITH
Active
Parent organization
KIMMIE C SMITH
Other names
SEAK Behavioral Health & Addiction Services
Organization subpart
Yes
Provider details
NPI number
Legal business name
KIMMIE C SMITH
Authorized official
KIMMIE C SMITH LPC (CHIEF EXECUTIVE OFFICER)
(907) 305-0985
Entity
Organization
Contact information
Practice address
817 ZIMOVIA HIGHWAY, APT 3, WRANGELL, AK 99929
(907) 305-0985
Mailing address
PO BOX 644, WRANGELL, AK 99929-0644
(907) 305-0985
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1717330
—
AK
Enumeration date
08/10/2022
Last updated
01/25/2024
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