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COOK INLET TRIBAL COUNCIL, INC

Rehabilitation, Substance Use Disorder >> Clinic/Center >> Ambulatory Health Care Facilities

Registrant NPI Number: 1437273000

Organizational Registrant:
Organization Name:  COOK INLET TRIBAL COUNCIL, INC
Organization is not Subpart
Authorized Official:  GLORIA  O'NEILL  PRESIDENT CEO  907--79-33600

Location and contact information for practice:
3600 SAN JERONIMO DRIVE  ANCHORAGE, AK 99508-2869 US
Tel: 907-793-3600  Fax: 907-793-3250

Contact information for business:
3600 SAN JERONIMO DRIVE  ANCHORAGE, AK 99508-2869 US
Tel: 907-793-3600  Fax: 907-793-3250

Registration Information:
NPI: 1437273000
Entity Type: Organization

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
X261QR0405XAmbulatory Health Care Facilities
Clinic/Center
Rehabilitation, Substance Use Disorder
AK88201
X324500000XResidential Treatment Facilities
Substance Abuse Rehabilitation Facility
AK88201

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
DA4469AK05




HEALTH CARE JOBS AK - Page 1



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