Organization
YUKON-KUSKOKWIM HEALTH CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHANE CARLLSON RN (RN)
(907) 543-6106
Entity
Organization
Contact information
Practice address
528 CHEIF EDDIE HOFFMEN, YUKON-KUSKOKWIM HEALTH CORPORATION, BETHEL, AK 99559-0528
(907) 546-6106
(907) 543-6159
Mailing address
PO BOX 528, YUKON-KUSKOKWIM HEALTH CORPORATION, BETHEL, AK 99559-0528
(907) 546-6106
(907) 543-6159
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
NUR R 27765
AK
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
NUR R 27765
AK
Other
Enumeration date
12/06/2012
Last updated
12/06/2012
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