Organization
MANIILAQ ASSOCIATION KSCCC
Active
Other names
Kotzebue Senior Citizens Cultural Center
Organization subpart
No
Provider details
NPI number
Authorized official
KELLIE B HAAS LPN (ELDER SERVICES DIRECTOR)
(907) 442-7917
Entity
Organization
Contact information
Practice address
607 WOLVERINE DRIVE, KOTZEBUE, AK 99752-1073
(907) 442-7917
(907) 442-7932
Mailing address
PO BOX 1073, KOTZEBUE, AK 99752-1073
(907) 442-7917
(907) 442-7932
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
234051
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
CMG590
—
AK
Enumeration date
03/08/2007
Last updated
08/22/2020
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