Organization
MANIILAQ ASSOCIATION
Active
Parent organization
MANIILAQ ASSOCIATION
Other names
Maniilaq Recovery Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
MANIILAQ ASSOCIATION
Authorized official
MS. SHERRY ANN KULUKHON CCDCI (TREATMENT SERVICES SUPERVISOR)
(907) 442-7648
Entity
Organization
Contact information
Practice address
435 SECOND STREET TED STEVENS WAY, KOTZEBUE, AK 99752-0256
(907) 442-7648
(907) 442-7821
Mailing address
435 SECOND STREET TED STEVENS WAY, PO BOX 256, KOTZEBUE, AK 99752-0256
(907) 442-7648
(907) 442-7821
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
3059
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
MHO 212
—
AK
Enumeration date
04/17/2007
Last updated
12/22/2008
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