Healthcare Provider Details

I. General information

NPI: 1467642017
Provider Name (Legal Business Name): NORTON SOUND HEALTH CORP.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/30/2007
Last Update Date: 07/30/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

305 5TH BERING STREET
NONE AK
99762
US

IV. Provider business mailing address

305 5TH BERING STREET P.O. BOX 966
NONE AK
99762
US

V. Phone/Fax

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

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code283Q00000X
TaxonomyPsychiatric Hospital
License Number2273
License Number StateAK

VIII. Authorized Official

Name: MR. ARNOLD OTTO ASHENFELTER
Title or Position: COUNSELOR-1
Credential: CCDC-1
Phone: 907-443-3311