BRISTOL BAY AREA HEALTH CORPORATION (NPI# 1114050911) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114050911 |
| Entity Type | Organization |
| Organization Name | BRISTOL BAY AREA HEALTH CORPORATION |
| Other Organization Name | JAKE'S PLACE |
| Practice Address |
6000 Kanakanak Road Dillingham AK 99576-0130 |
| Mailing Address |
Po Box 130 Dillingham AK 99576-0130 |
| Practice Telephone | 9078425201 |
| Practice Fax Number | 9078429250 |
| Mailing Telephone | 9048425201 |
| Mailing Fax Number | 9048429250 |
| Enumeration Date | 2007-03-13 |
| Last Update Date | 2013-04-04 |
| Authorized Official Name | MR. ROBERT J CLARK (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Telephone | 9078425201 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 324500000X | Substance Abuse Rehabilitation Facility | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AK | DA4432 | 05 |
| Other Name | Type Code |
|---|---|
| JAKE'S PLACE | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427119874 | Bristol Bay Area Health Corporation | Clinic/Center | Main Steet, Portage Creek, AK 99576 | 2006-12-12 |
| 1396292751 | Bristol Bay Area Health Corporation | Hearing Aid Equipment | 6000 Kanakanak Rd., Dillingham, AK 99576-0130 | 2016-09-02 |
| 1154551588 | Bristol Bay Area Health Corporation | Optometrist | 6000 Kanakanak Rd, Dillingham, AK 99576 | 2009-07-20 |
| 1962688309 | Bristol Bay Area Health Corporation | General Acute Care Hospital | 6000 Kanakanak Rd, Dillingham, AK 99576-0130 | 2008-01-16 |
| 1497954556 | Bristol Bay Area Health Corporation | Case Management | 6000 Kanakanak Rd, Dillingham, AK 99576 | 2007-07-17 |
| 1689873739 | Bristol Bay Area Health Corporation | Family Medicine | 6000 Kanakanak Rd, Dillingham, AK 99576 | 2007-07-17 |
| 1770782831 | Bristol Bay Area Health Corporation | Dentist | 6000 Kanakanak Rd, Dillingham, AK 99576 | 2007-07-17 |
| 1972702025 | Bristol Bay Area Health Corporation | Family Medicine | 6000 Kanakanak Rd, Dillingham, AK 99576 | 2007-07-17 |
| 1295868289 | Bristol Bay Area Health Corporation | Community/Behavioral Health | 6000 Kanakanak Road, Dillingham, AK 99576 | 2007-03-13 |
| 1336272095 | Bristol Bay Area Health Corporation | Pharmacy | 6000 Kanakanak Road, Dillingham, AK 99576 | 2007-03-13 |
| Street Address |
6000 KANAKANAK ROAD |
| City | DILLINGHAM |
| State | AK |
| Zip Code | 99576-0130 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740271741 | Jacqueline Elizabeth Chase | Dietitian, Registered | 6000 Kanakanak Road, Dillingham, AK 99576-0130 | 2005-10-31 |
| 1306475140 | Nellie Alakayak | Community Health Worker | 6000 Kanakanak Road, Dillingham, AK 99576-0130 | 2020-04-03 |
| 1336701663 | Alisha Marie Folsom | Registered Nurse | 6000 Kanakanak Road, Dillingham, AK 99576-0130 | 2019-07-08 |
| 1154983484 | Starla Fox | Registered Nurse | 6000 Kanakanak Road, Dillingham, AK 99576 | 2019-07-08 |
| 1922534098 | Acacia Walton | Specialist | 6000 Kanakanak Road, Dillingham, AK 99576 | 2017-05-10 |
| 1477091791 | Kathleen Sando | Case Manager/Care Coordinator | 6000 Kanakanak Road, Dillingham, AK 99576 | 2017-02-07 |
| 1225491160 | Candace Summer Watts | Family Medicine | 6000 Kanakanak Road, Bbahc, Dillingham, AK 99576 | 2016-03-29 |
| 1588025738 | Carolyn Carlos | Community Health Worker | 6000 Kanakanak Road, Dillingham, AK 99576-0130 | 2016-03-16 |
| 1508259383 | Leigh Ann Bolin | Social Worker | 6000 Kanakanak Road, Dillingham, AK 99576-0130 | 2015-03-18 |
| 1811388820 | Jennifer Bennis | Case Manager/Care Coordinator | 6000 Kanakanak Road, Dillingham, AK 99576-0130 | 2015-02-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174016737 | Lake Road Dental LLC | Clinic/Center | 4622 Shannon Lake Rd, Dillingham, AK 99576 | 2018-06-08 |
| 1053837823 | Guardian Flight LLC | Ambulance | Beluga Bluffs Apt Block 26, Lot 5 Apt. 5 & 6, Dillingham, AK 99576 | 2017-08-14 |
| 1467820910 | Alicia Mahlow | Case Manager/Care Coordinator | 540 Gauthier Way, Dillingham, AK 99576 | 2015-09-14 |
| 1306100557 | Peter Tallman | Social Worker | 6000 Kanakanak, Dillingham, AK 99576 | 2012-07-02 |
| 1801079546 | Marrulut Eniit Assisted Living, Inc | Respite Care | 125 D Street, Dillingham, AK 99576 | 2007-12-17 |
| 1730393430 | City of Dillingham | Ambulance | 514 Main Street, Dillingham, AK 99576 | 2007-05-10 |
| 1023132792 | City of Dillingham Senior Center | Non-emergency Medical Transport (VAN) | 515 East 1st Ave, Dillingham, AK 99576 | 2007-03-19 |
| 1912037037 | Hope Community Resources Inc | Day Training, Developmentally Disabled Services | Chog Center Main Street, Dillingham, AK 99576 | 2007-03-07 |
| 1427119874 | Bristol Bay Area Health Corporation | Clinic/Center | Main Steet, Portage Creek, AK 99576 | 2006-12-12 |
| 1396728614 | Joan Lucienne Junge | Nurse Practitioner | 1500 Kanakanak Rd, Dillingham, AK 99576 | 2005-11-21 |
| Find all providers in zip 99576 | ||||
| Taxonomy Code | 324500000X |
| Grouping | Residential Treatment Facilities |
| Classification | Substance Abuse Rehabilitation Facility |
| A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances. |
| Notes: [7/1/2003: modified title, modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780220012 | Set Free Alaska, Inc. | Substance Abuse Rehabilitation Facility | 51310 Timber Bay Court, Homer, AK 99603-9968 | 2019-11-21 |
| 1811532575 | Set Free Alaska, Inc. | Substance Abuse Rehabilitation Facility | 1130 Ocean Dr Ste A, Homer, AK 99603-7919 | 2019-11-16 |
| 1992281034 | Akeela Inc | Substance Abuse Rehabilitation Facility | 2804 Bering St, Anchorage, AK 99503-3820 | 2018-07-12 |
| 1508393869 | Ground Zero Wellness Center | Substance Abuse Rehabilitation Facility | 4670 Killen Ln, Fairbanks, AK 99709-3325 | 2017-05-17 |
| 1306394960 | Akeela Inc | Substance Abuse Rehabilitation Facility | 561 S Denali St Ste F, Palmer, AK 99645-6464 | 2016-09-13 |
| 1730582446 | Starting Point | Substance Abuse Rehabilitation Facility | 230 E Paulson Ave, 76, Wasilla, AK 99654-7001 | 2014-10-08 |
| 1003005828 | Maniilaq Association | Substance Abuse Rehabilitation Facility | 722 Second Ave, Kotzebue, AK 99752-0256 | 2007-10-17 |
| 1518158245 | Norton Sound Regional Hospital | Substance Abuse Rehabilitation Facility | 3rd Ave, Unalakleet, AK 99684 | 2007-08-07 |
| 1184814667 | Norton Sound Health Corp | Substance Abuse Rehabilitation Facility | 305 5th & Bering Street, Nome, AK 99762 | 2007-07-31 |
| 1205036548 | Norton Sound Health Corporation | Substance Abuse Rehabilitation Facility | 306 5th Ave. W, Nome, AK 99762 | 2007-07-24 |
| Find all providers with the same taxonomy | ||||
| City | DILLINGHAM |
| Zip Code | 99576 |
Please comment or provide details below to improve the information on BRISTOL BAY AREA HEALTH CORPORATION.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.