| Bristol Bay Area Health Corporation | |
|
36 Alder Dr. Chignik Lake AK 99548-0036 | |
| (907) 845-2236 | |
| (907) 845-2353 |
| Full Name | Bristol Bay Area Health Corporation |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 36 Alder Dr., Chignik Lake, Alaska |
| Authorized Official Name and Position | Cathy Leeann Taylor (PROVIDER ENROLLMENT SPECIALIST) |
| Authorized Official Contact | 9078425201 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bristol Bay Area Health Corporation P.o. Box 36 Chignik Lake AK 99548 Ph: (907) 845-2236 | Bristol Bay Area Health Corporation 36 Alder Dr. Chignik Lake AK 99548-0036 Ph: (907) 845-2236 |
| NPI Number | 1396097614 |
|---|---|
| Provider Enumeration Date | 10/10/2012 |
| Last Update Date | 04/30/2021 |
| Certification Date | 04/30/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396097614 | NPI | - | NPPES |
| 1114050911 | Medicaid | AK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (Alaska) | Primary |
Bristol Bay Counseling Center Chignik Lake Clinic Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2336 Alder Lane, Chignik Lake, AK 99548 Phone: 907-842-1230 Fax: 907-842-5174 |