Organization
KENAI PENINSULA COMMUNITY CARE CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS TAMARA J. BIDWELL (EXECUTIVE DIRECTOR)
(907) 283-7635
Entity
Organization
Contact information
Practice address
320 S SPRUCE ST, KENAI, AK 99611-7939
(907) 283-7635
(907) 283-9575
Mailing address
320 S SPRUCE ST, KENAI, AK 99611-7939
(907) 283-7635
(907) 283-9575
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
311415
AK
Other
Enumeration date
02/06/2007
Last updated
08/22/2020
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