KENAI PENINSULA COMMUNITY CARE EMERGENCY NPI 1689015794

NPI Information

NPI: 1689015794
Provider Name: KENAI PENINSULA COMMUNITY CARE EMERGENCY
Classification: Residential Treatment Facility, Emotionally Disturbed Children - 322D00000X
Entity Type: Organization
Address:
320 S SPRUCE ST
KENAI, AK
ZIP 99611
Phone: (907) 283-7635
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KENAI PENINSULA COMMUNITY CARE EMERGENCY is a residential treatment facility emotionally disturbed children in Kenai, AK. The provider is a residential facility that provides habilitation services and other care and treatment to children diagnosed with mental health illness, behavioral issues, and intellectual disabilities and are not able to live independently. KENAI PENINSULA COMMUNITY CARE EMERGENCY NPI is 1689015794. The provider is registered as an organization entity type.

The provider's business location address is:

320 S SPRUCE ST
KENAI, AK
ZIP 99611-939
Phone: (907) 283-7635
Fax: (907) 283-9575

The provider's authorized official is Tamara Bidwell .
The authorized official title is Executive Director and has the following contact phone number (907) 283-7635.

The enumeration date for this NPI number is 7/17/2013 and was last updated on 7/17/2013.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	322D00000X	Residential Treatment Facility, Emotionally Disturbed Children			ALASKA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	MH6326	MEDICAID	ALASKA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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