Provider Demographics
NPI:1174674881
Name:COUNCIL OF ATHABASCAN TRIBAL GOVERNMENTS
Entity Type:Organization
Organization Name:COUNCIL OF ATHABASCAN TRIBAL GOVERNMENTS
Other - Org Name:YUKON FLATS HEALTH CENTER
Other - Org Type:Other Name
Authorized Official - Title/Position:DIABETIC EDUCATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:M
Authorized Official - Last Name:AKIN
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:907-662-2460
Mailing Address - Street 1:PO BOX 83123
Mailing Address - Street 2:
Mailing Address - City:FAIRBANKS
Mailing Address - State:AK
Mailing Address - Zip Code:99708-3123
Mailing Address - Country:US
Mailing Address - Phone:907-590-0945
Mailing Address - Fax:907-662-2709
Practice Address - Street 1:309 SPRUCE ST.
Practice Address - Street 2:
Practice Address - City:FORT YUKON
Practice Address - State:AK
Practice Address - Zip Code:99740-0309
Practice Address - Country:US
Practice Address - Phone:907-662-2460
Practice Address - Fax:907-662-2709
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK15134163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Multi-Specialty