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General NPI Number Information
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NPI Number | 1346466232
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Entity Type | Organization
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Legal Business Name | YUKON KUSKOKWIM HEALTH CORP
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Dates
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Enumeration Date | 04/18/2007
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Last Update Date | 02/04/2014
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Provider Practice Location Address
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Address Line | 829 CHIEF EDDIE HOFFMAN HWY SUITE 340
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City | BETHEL
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State | AK
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Zip | 99559
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Country | US
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Telephone | 907-543-6000
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Fax | 907-543-6117
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Provider Business Mailing Address
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Address Line | PO BOX 528
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City | BETHEL
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State | AK
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Zip | 99559-0528
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Country | US
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Telephone | 907-543-6000
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Fax | 907-543-6117
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | DANIEL WINKELMAN
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Credential |
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Telephone | 907-543-6032
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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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 | 373H00000X
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Taxonomy Name | Day Training/Habilitation Specialist
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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 | 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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