Organization
MANIILAQ ASSOCIATION KSCCC
Active
Other names
Kotzebue Senior Citizens Cultural Center
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. 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
310400000X
Assisted Living Facility
Primary
000063
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
CMG590
—
AK
05
—
RL3590
—
AK
Enumeration date
03/08/2007
Last updated
08/22/2020
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