Healthcare Provider Details

I. General information

NPI: 1932158003
Provider Name (Legal Business Name): VALDEZ SENIOR CITIZENS CENTER, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/08/2006
Last Update Date: 04/14/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1300 E. HANAGITA PLACE
VALDEZ AK
99686-1635
US

IV. Provider business mailing address

PO BOX 1635
VALDEZ AK
99686-1635
US

V. Phone/Fax

Practice location:
  • Phone: 907-835-5032
  • Fax: 907-835-2518
Mailing address:
  • Phone: 907-835-5032
  • Fax: 907-835-2518

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. SHARON GAIL KEESE
Title or Position: PROGRAM MANAGER
Credential:
Phone: 907-835-5032