Providence Kodiak Island Counseling Center

NPI #1093147589 in Kodiak, Alaska

Provider Information

NPI Number: 1093147589
Entity Type: Organization
Organization Name: Providence Kodiak Island Counseling Center
Subpart: Yes (part of a larger organization)
Parent Organization: PROVIDENCE HEALTH AND SERVICES
Primary Specialty: Case Management
Enumeration Date: Aug 6, 2013
Last Updated: Aug 6, 2013

Practice Location

Address: 717 E REZANOF DR
City: Kodiak
State: Alaska
ZIP Code: 99615-6416
Phone: (907) 481-2400

Authorized Official

Name: MRS. VERONICA SAMANIEGO, BA
Title: CASE MNANAGER
Phone: (907) 481-2400

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Case Management	251B00000X	Primary

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