Healthcare Provider Details

I. General information

NPI: 1205036548
Provider Name (Legal Business Name): NORTON SOUND HEALTH CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/24/2007
Last Update Date: 07/24/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

306 5TH AVE. W
NOME AK
99762
US

IV. Provider business mailing address

PO BOX 966
NOME AK
99762-0966
US

V. Phone/Fax

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

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. BRIDIE ROSE TRAINOR
Title or Position: COUNSELOR / CASE MANAGER
Credential: B.A.
Phone: 907-443-4576