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General NPI Number Information
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NPI Number | 1558569251
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Entity Type | Organization
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Legal Business Name | CHRYSTAL VAN SKY
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Dates
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Enumeration Date | 07/05/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 53908 TIAGA WAY
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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 | 907-773-5273
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Fax | 907-776-7081
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Provider Business Mailing Address
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Address Line | 53908 TIAGA WAY
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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 | 907-776-5273
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Fax | 907-776-7081
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Authorized Official
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Title or Position | OWNER-CARE COORDINATOR
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Name | CHRYSTAL VAN SKY
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Credential | BSW
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Telephone | 907-776-5273
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State | AK
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