Organization
KETCHIKAN INDIAN COMMUNITY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SUE PICKRELL (DIRECTOR OF BEHAVIORAL HEALTH)
(907) 228-4917
Entity
Organization
Contact information
Practice address
2960 TONGASS AVE, KETCHIKAN, AK 99901-5742
(907) 228-4917
(907) 228-4920
Mailing address
2960 TONGASS AVE, KETCHIKAN, AK 99901-5742
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
1300
OH
251S00000X
Community/Behavioral Health Agency
C.0501146
OH
Other
Enumeration date
03/10/2008
Last updated
05/03/2010
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