Organization
COOK INLET COUNCIL ON ALCOHOL AND DRUG ABUSE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. HENRY NOVAK BA (EXECUTIVE DIRECTOR)
(907) 283-3658
Entity
Organization
Contact information
Practice address
126 W PIONEER AVE STE 11, HOMER, AK 99603-7564
(907) 235-8001
(907) 235-8099
Mailing address
PO BOX 882, KENAI, AK 99611-0882
(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
—
DA8820
—
AK
Enumeration date
04/10/2007
Last updated
08/22/2020
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