Healthcare Provider Details

I. General information

NPI: 1417992215
Provider Name (Legal Business Name): ALEUTIAN PRIBILOF ISLANDS ASSOCIATION INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/17/2006
Last Update Date: 02/22/2021
Certification Date: 02/03/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

34 LAVELLE CT OONALASKA WELLNESS CENTER BEHAVIORAL HEALTH
UNALASKA AK
99685
US

IV. Provider business mailing address

1131 E INTERNATIONAL AIRPORT RD
ANCHORAGE AK
99518-1408
US

V. Phone/Fax

Practice location:
  • Phone: 907-276-2700
  • Fax: 907-581-2752
Mailing address:
  • Phone: 907-276-2700
  • Fax: 907-222-4295

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number StateAK
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number StateAK

VIII. Authorized Official

Name: MR. DIMITRI PHILEMONOF
Title or Position: CEO PRESIDENT
Credential:
Phone: 907-276-2700