Organization
MANIILAQ ASSOCIATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HELEN BOLEN (PRESIDENT)
(907) 442-3311
Entity
Organization
Contact information
Practice address
818 LAKE STREET, KOTZEBUE, AK 99752
(907) 442-3776
(907) 442-4375
Mailing address
PO BOX 256, KOTZEBUE, AK 99752
(907) 442-3776
(907) 442-4375
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
CMG461
—
AK
Enumeration date
04/02/2007
Last updated
08/08/2007
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