Organization
KAWERAK INC
Active
Other names
Jacobs House
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LORETTA BULLARD (PRESIDENT)
(907) 443-5231
Entity
Organization
Contact information
Practice address
407 K STREET, NOME, AK 99762
(907) 443-8096
(907) 443-2708
Mailing address
PO BOX 948, P.O. BOX 948, NOME, AK 99762-0948
(907) 443-8096
(907) 443-2708
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
400297
AK
Other
Enumeration date
04/26/2007
Last updated
07/08/2008
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