Organization
COOK INLET COUNCIL ON ALCOHOL AND DRUG ABUSE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HENRY KRISTOFOR NOVAK B.S. (EXECUTIVE DIRECTOR)
(907) 283-3658
Entity
Organization
Contact information
Practice address
10200 KENAI SPUR HWY, KENAI, AK 99611-7807
(907) 283-3658
(907) 283-5046
Mailing address
10200 KENAI SPUR HWY, KENAI, AK 99611-7807
(907) 283-3658
(907) 283-5046
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
DA1230
—
AK
Enumeration date
01/17/2007
Last updated
08/22/2020
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