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General NPI Number Information
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NPI Number | 1053293878
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Entity Type | Organization
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Legal Business Name | KENAITZE INDIAN TRIBE
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Dates
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Enumeration Date | 07/23/2025
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Last Update Date | 07/30/2025
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Provider Practice Location Address
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Address Line | 12271 SOUTH FOREST DRIVE
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City | KENAI
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State | AK
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Zip | 99611
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Country | US
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Telephone | 907-335-7636
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 988
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City | KENAI
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State | AK
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Zip | 99611-0988
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Country | US
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Telephone | 907-335-7500
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF FINANCE
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Name | GREG BURNETT
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Credential |
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Telephone | 907-335-7635
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 163WS0200X
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Taxonomy Name | School Registered Nurse
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 261QF0400X
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Taxonomy Name | Federally Qualified Health Center (FQHC)
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License Number |
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License Number State |
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