Organization
MANIILAQ ASSOCIATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ERIN JACOBS (DIRECTOR OF PATIENT FINANCIAL SERVI)
(907) 442-7238
Entity
Organization
Contact information
Practice address
733 2ND AVE, KOTZEBUE, AK 99752
(907) 442-7238
(907) 442-7403
Mailing address
PO BOX 43, KOTZEBUE, AK 99752-0043
(907) 442-7238
(907) 442-7403
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1021015
—
AK
Enumeration date
06/30/2020
Last updated
06/30/2020
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