YUKON KUSKOKWIM HEALTH CORPORATION (NPI# 1346452034) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1346452034 |
| Entity Type | Organization |
| Organization Name | YUKON KUSKOKWIM HEALTH CORPORATION |
| Practice Address |
829 Chief Eddie Hoffman Hwy Bethel AK 99559 |
| Mailing Address |
Po Box 528 Bethel AK 99559-0528 |
| Practice Telephone | 9075436100 |
| Enumeration Date | 2007-05-04 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | GENE PELTOLA (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Telephone | 9075436020 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 322D00000X | Residential Treatment Facility, Emotionally Disturbed Children | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AK | BR1414 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316180029 | Yukon Kuskokwim Health Corporation | Clinic/Center | 49 Airport Rd, Hooper Bay, AK 99604 | 2009-04-10 |
| 1689857658 | Yukon Kuskokwim Health Corporation | Clinic/Center | 10 Morgan Road, Aniak Subregional Clinic, Aniak, AK 99557 | 2007-12-12 |
| 1124201199 | Yukon Kuskokwim Health Corporation | Clinic/Center | 246 Kwiguk Street, Emmonak Subregional Clinic, Emmonak, AK 99581 | 2007-12-12 |
| 1851574826 | Yukon Kuskokwim Health Corporation | Clinic/Center | 310 Hospital Road, St. Mary's Subregional Clinic, St. Mary's, AK 99658 | 2007-12-12 |
| 1497938476 | Yukon Kuskokwim Health Corporation | Clinic/Center | 37028 Clinic Road, Toksook Bay Subregional Clinic, Toksook Bay, AK 99637 | 2007-12-12 |
| 1316151962 | Yukon Kuskokwim Health Corporation | Supports Brokerage | 829 Chief Eddie Hoffman Hwy, Bethel, AK 99559-0528 | 2007-05-10 |
| 1316159684 | Yukon Kuskokwim Health Corporation | Residential Treatment Facility, Emotionally Disturbed Children | 829 Chief Eddie Hoffman Hwy, Bethel, AK 99559 | 2007-05-07 |
| 1194945170 | Yukon Kuskokwim Health Corporation | Counselor | 829 Chief Eddie Hoffman Hwy, Bethel, AK 99559 | 2007-05-01 |
| 1528285582 | Yukon Kuskokwim Health Corporation | Community Health Worker | 829 Chief Eddie Hoffman Hwy, Suite 340, Bethel, AK 99559 | 2007-04-19 |
| Street Address |
829 CHIEF EDDIE HOFFMAN HWY |
| City | BETHEL |
| State | AK |
| Zip Code | 99559 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679542484 | Peter Robert Hergenroether | Counselor | 829 Chief Eddie Hoffman Hwy, Bethel, AK 99559 | 2006-03-15 |
| 1376142174 | Thomasina Tishina Smith | Community Health Worker | 829 Chief Eddie Hoffman Hwy, Bethel, AK 99559-0528 | 2020-10-22 |
| 1508478751 | Moses K Ayagalria Jr. | Counselor | 829 Chief Eddie Hoffman Hwy, Suite 150, Bethel, AK 99559-0528 | 2020-08-19 |
| 1720699044 | Reanna Jimmy | Community Health Worker | 829 Chief Eddie Hoffman Hwy, Bethel, AK 99559-0528 | 2020-08-11 |
| 1891306387 | David Mochin | Counselor | 829 Chief Eddie Hoffman Hwy, Suite 150, Bethel, AK 99559-0528 | 2020-08-10 |
| 1396355053 | Lucy Ann Mochin | Counselor | 829 Chief Eddie Hoffman Hwy, Bethel, AK 99559-0528 | 2020-08-06 |
| 1467074518 | Tawanda Moses | Case Manager/Care Coordinator | 829 Chief Eddie Hoffman Hwy, Bethel, AK 99559 | 2020-05-12 |
| 1922635101 | Alice Lucy Leinberger | Case Manager/Care Coordinator | 829 Chief Eddie Hoffman Hwy, Suite 327, Bethel, AK 99559-0528 | 2020-03-26 |
| 1700413663 | Erica Kameroff | Community Health Worker | 829 Chief Eddie Hoffman Hwy, Suite 150, Bethel, AK 99559-0528 | 2020-03-23 |
| 1386283356 | D'angela Yvette Nickerson | Counselor | 829 Chief Eddie Hoffman Hwy, Suite 150, Bethel, AK 99559-0528 | 2019-12-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194337519 | Michael P Nicolai | Case Manager/Care Coordinator | 829 Chief Eddie Hoffman Hey, Bethel, AK 99559 | 2020-08-18 |
| 1003438508 | Enc Physical Therapy LLC | Physical Therapist | 223 Blackberry Street, Unit A, Bethel, AK 99559 | 2020-05-07 |
| 1780229609 | Laline Knox | Massage Therapist | 107 Alex Hatley Ste 1, Bethel, AK 99559 | 2019-11-14 |
| 1659920502 | Ana Celina Sebastian | Counselor | 1380 Calista Dr, Bethel, AK 99559 | 2019-09-04 |
| 1639730484 | Jerri Linda Moran-gentle | Massage Therapist | 430 A 7th Ave, Bethel, AK 99559 | 2019-06-24 |
| 1528625381 | Jennifer Peeks | Social Worker | 631 4th Ave. & Main St., Bethel, AK 99559 | 2019-05-28 |
| 1710451190 | Mary Theresa Thibeault | Registered Nurse | Bethel Public Health Center, 1490 Eddie Hoffman Highway, Bethel, AK 99559 | 2019-01-18 |
| 1659846210 | Freda Lizann Jimmie | Counselor | 829 Eddie Hoffman Highway, Bethel, AK 99559 | 2018-10-10 |
| 1073093977 | Romeo Mullai | Counselor | 1630 Calista Drive, Bethel, AK 99559 | 2018-08-20 |
| 1235623794 | Brian Justin Moses | Day Training/Habilitation Specialist | 841 Chief Eddie Hoffman Highway, Bethel, AK 99559 | 2018-06-19 |
| Find all providers in zip 99559 | ||||
| Taxonomy Code | 322D00000X |
| Grouping | Residential Treatment Facilities |
| Classification | Residential Treatment Facility, Emotionally Disturbed Children |
| A provider facility or distinct part of the organization which renders an interdisciplinary program of mental health treatment to individuals under 21 years of age who have persistent dysfunction in major life areas. The dysfunction is of an extent and pervasiveness that requires a protected and highly structured therapeutic environment. These organizations, or distinct part of organizations, exclude those that provide acute psychiatric care, partial hospitalization, group living, therapeutic schooling, primary diagnosis substance abuse disorder treatment, or primary diagnosis mental retardation or developmental disability treatment. |
| Notes: Source: U.S. Department of Defense Regulation 6010.8-R, Chapter 6. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316159684 | Yukon Kuskokwim Health Corporation | Residential Treatment Facility, Emotionally Disturbed Children | 829 Chief Eddie Hoffman Hwy, Bethel, AK 99559 | 2007-05-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982228177 | Juneau Youth Services, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 8460 Rainbow Row, Juneau, AK 99801-9041 | 2020-06-03 |
| 1447874631 | Juneau Youth Services, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 10815 Black Bear Rd, Juneau, AK 99801-8783 | 2020-06-03 |
| 1043834245 | Juneau Youth Services, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 10685 Mendenhall Loop Rd, Juneau, AK 99801 | 2020-06-03 |
| 1295359511 | Juneau Youth Services, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 10801 Black Bear Rd, Juneau, AK 99801 | 2020-06-02 |
| 1700400033 | Juneau Youth Services, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 10685 Mendenhall Lp Rd, Juneau, AK 99801 | 2020-06-02 |
| 1417502998 | Christopher Robert Jackson | Residential Treatment Facility, Emotionally Disturbed Children | 1502 Liatris Ln, North Pole, AK 99705-5082 | 2019-08-01 |
| 1326396821 | Presbyterian Hospitality House | Residential Treatment Facility, Emotionally Disturbed Children | 2771 E Hiawatha Dr, Wasilla, AK 99654-2853 | 2012-08-15 |
| 1598013096 | Presbyterian Hospitality House | Residential Treatment Facility, Emotionally Disturbed Children | 1145 W Granville St, Palmer, AK 99645-7118 | 2012-08-15 |
| 1639425812 | Presbyterian Hospitality House | Residential Treatment Facility, Emotionally Disturbed Children | 6969 S Hood Ct, Wasilla, AK 99624 | 2012-07-25 |
| 1457528366 | Boys and Girls Home of Alaska | Residential Treatment Facility, Emotionally Disturbed Children | 3101 Lathrop Street, Fairbanks, AK 99707-0870 | 2008-05-09 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on YUKON KUSKOKWIM 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.