YUKON-KUSKOKWIM HEALTH CORPORATION (NPI# 1467679936) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467679936 |
| Entity Type | Organization |
| Organization Name | YUKON-KUSKOKWIM HEALTH CORPORATION |
| Practice Address |
5016 Noel Polty Blvd. Bethel AK 99559 |
| Mailing Address |
Po Box 528 Bethel AK 99559-0528 |
| Practice Telephone | 9075436800 |
| Practice Fax Number | 9075437101 |
| Mailing Telephone | 9075436000 |
| Enumeration Date | 2007-04-19 |
| Last Update Date | 2013-07-31 |
| Authorized Official Name | EUGENE R PELTOLA (PRESIDENT & CEO) |
| Authorized Official Telephone | 9075436020 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers | ||
| Y | 323P00000X | Psychiatric Residential Treatment Facility | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AK | HS414PI | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821476599 | Yukon-kuskokwim Health Corporation | Clinic/Center | 1260 A Chief Eddie Hoffman Hwy, Bethel, AK 99559 | 2015-05-13 |
| 1821438342 | Yukon-kuskokwim Health Corporation | Skilled Nursing Facility | 1100 Chief Eddie Hoffman Hwy, Bethel, AK 99559 | 2013-06-28 |
| 1346585056 | Yukon-kuskokwim Health Corporation | Clinic/Center | 528 Cheif Eddie Hoffmen, Yukon-kuskokwim Health Corporation, Bethel, AK 99559-0528 | 2012-12-06 |
| 1306299714 | Yukon-kuskokwim Health Corporation | Transportation Broker | 700 Chief Eddie Hoffman Hwy, Bethel, AK 99559 | 2016-07-20 |
| 1457565731 | Yukon-kuskokwim Health Corporation | Case Management | 829 Chief Eddie Hoffman Hwy, Bethel, AK 99559-0528 | 2007-05-09 |
| 1518170836 | Yukon-kuskokwim Health Corporation | Case Management | 829 Chief Eddie Hoffman Hwy, Bethel, AK 99559-0528 | 2007-05-07 |
| 1447477815 | Yukon-kuskokwim Health Corporation | Counselor | 700 Chief Eddie Hoffman Hwy, Bethel, AK 99559 | 2007-04-19 |
| 1689719825 | Yukon-kuskokwim Health Corporation | Pharmacy | 700 Chief Eddie Hoffman Hwy, Bethel, AK 99559-0827 | 2007-02-21 |
| 1063567691 | Yukon-kuskokwim Health Corporation | Clinic/Center | 700 Chief Eddie Hoffman Hwy, Bethel, AK 99559 | 2007-01-24 |
| Street Address |
5016 NOEL POLTY BLVD. |
| City | BETHEL |
| State | AK |
| Zip Code | 99559 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023120722 | Mary Elizabeth Mcdonald | Counselor | 5016 Noel Polty Blvd., Bethel, AK 99559-1029 | 2006-08-31 |
| 1992317945 | Jonathan Ocampo | Counselor | 5016 Noel Polty Blvd., Bethel, AK 99559-1029 | 2020-08-20 |
| 1578174520 | Leo Bays | Counselor | 5016 Noel Polty Blvd., Bethel, AK 99559 | 2020-08-13 |
| 1417568726 | Axel Edward Anaruk II | Counselor | 5016 Noel Polty Blvd., Bethel, AK 99559-1029 | 2020-08-11 |
| 1922630680 | Noah Hale | Counselor | 5016 Noel Polty Blvd., Bethel, AK 99559-0528 | 2020-02-10 |
| 1295366359 | Jefferson Caramat | Counselor | 5016 Noel Polty Blvd., Bethel, AK 99559-1029 | 2020-01-28 |
| 1659927911 | Nikki Lorraine Alexie | Counselor | 5016 Noel Polty Blvd., Bethel, AK 99559-1029 | 2019-08-13 |
| 1093281834 | Raymond Walter Long I | Counselor | 5016 Noel Polty Blvd., Bethel, AK 99559 | 2018-10-19 |
| 1801379938 | Rachael Naomi Baugh | Counselor | 5016 Noel Polty Blvd., Bethel, AK 99559-1029 | 2018-09-14 |
| 1114400082 | Tabitha Jennifer Kaganak | Counselor | 5016 Noel Polty Blvd., Bethel, AK 99559 | 2018-09-07 |
| 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 | 323P00000X |
| Grouping | Residential Treatment Facilities |
| Classification | Psychiatric Residential Treatment Facility |
| A residential treatment facility (RTF) is a facility or distinct part of a facility that provides to children and adolescents, a total, twenty-four hour, therapeutically planned group living and learning situation where distinct and individualized psychotherapeutic interventions can take place. Residential treatment is a specific level of care to be differentiated from acute, intermediate, and long-term hospital care, when the least restrictive environment is maintained to allow for normalization of the patient’s surroundings. The RTF must be both physically and programmatically distinct if it is a part or subunit of a larger treatment program. An RTF is organized and professionally staffed to provide residential treatment of mental disorders to children and adolescents who have sufficient intellectual potential to respond to active treatment (that is, for whom it can reasonably be assumed that treatment of the mental disorder will result in an improved ability to function outside the RTF) for whom outpatient treatment, partial hospitalization or protected and structured environment is medically or psychologically necessary |
| Notes: Source: Champus Policy manual, Volume II, p. 6010.47M dated 9/12/94. Revision: Definition title revised 7/1/03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710149661 | Southcentral Foundation | Psychiatric Residential Treatment Facility | 3550 Cottonwood St, Anchorage, AK 99508-4352 | 2008-07-01 |
| 1194987370 | Southcentral Foundation | Psychiatric Residential Treatment Facility | 4353 Rendezvous Cir, Anchorage, AK 99504-4219 | 2008-06-27 |
| 1861698623 | Southcentral Foundation | Psychiatric Residential Treatment Facility | 1701 Cleveland Ave, Anchorage, AK 99517-2689 | 2007-06-26 |
| 1437271400 | Alaska Children's Services, Inc. | Psychiatric Residential Treatment Facility | 4600 Abbott Rd, Anchorage, AK 99507 | 2007-04-03 |
| 1689749939 | Frontline Residential Treatment Center LLC | Psychiatric Residential Treatment Facility | Mile 2.5 Clark Wolverine Rd, Palmer, AK 99645 | 2006-11-22 |
| 1356416101 | Frontline Residential Treatment Center LLC | Psychiatric Residential Treatment Facility | 1500 Debarr Circle, Anchorage, AK 99508 | 2006-11-21 |
| 1841364957 | Frontlline Residential Treatment Center LLC | Psychiatric Residential Treatment Facility | 1650 Bragaw St, Anchorage, AK 99508-3435 | 2006-11-20 |
| 1659483113 | Providence Health & Services - Washington | Psychiatric Residential Treatment Facility | 3210 W 62nd Ave, Anchorage, AK 99502 | 2006-08-31 |
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| 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.