Healthcare Provider Details

I. General information

NPI: 1184814667
Provider Name (Legal Business Name): NORTON SOUND HEALTH CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/31/2007
Last Update Date: 07/31/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

305 5TH & BERING STREET
NOME AK
99762
US

IV. Provider business mailing address

515 LOMAN STREET APT. #4
NOME AK
99762
US

V. Phone/Fax

Practice location:
  • Phone: 907-443-3311
  • Fax:
Mailing address:
  • Phone: 907-443-4515
  • Fax: 907-443-5915

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State

VIII. Authorized Official

Name: MS. SOPHIE NOTHSTINE
Title or Position: GROUP LIVING TECHNICIAN
Credential: COUNSELOR
Phone: 907-443-4515