Provider Demographics
NPI:1023374337
Name:METLAKATLA INDIAN COMMUNITY
Entity Type:Organization
Organization Name:METLAKATLA INDIAN COMMUNITY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SERVICE UNIT DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:RACHAEL
Authorized Official - Middle Name:SARAH
Authorized Official - Last Name:ASKREN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:907-886-6601
Mailing Address - Street 1:PO BOX 439
Mailing Address - Street 2:563 BRENDIBLE STREET
Mailing Address - City:METLAKATLA
Mailing Address - State:AK
Mailing Address - Zip Code:99926
Mailing Address - Country:US
Mailing Address - Phone:907-886-6601
Mailing Address - Fax:907-886-6976
Practice Address - Street 1:563 BRENDIBLE STREET
Practice Address - Street 2:
Practice Address - City:METLAKATLA
Practice Address - State:AK
Practice Address - Zip Code:99926
Practice Address - Country:US
Practice Address - Phone:907-886-6601
Practice Address - Fax:907-886-6976
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-11
Last Update Date:2012-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, OtherGroup - Single Specialty