Provider Demographics
NPI:1245585934
Name:ONC ADULT DAY SERVICES
Entity Type:Organization
Organization Name:ONC ADULT DAY SERVICES
Other - Org Name:ORUTSARAMIUT NATIVE COUNCIL
Other - Org Type:Other Name
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:LOUISE
Authorized Official - Middle Name:
Authorized Official - Last Name:CHARLES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:907-543-3988
Mailing Address - Street 1:127 ATSAQ STREET
Mailing Address - Street 2:P.O. BOX 927
Mailing Address - City:BETHEL
Mailing Address - State:AK
Mailing Address - Zip Code:99559-0927
Mailing Address - Country:US
Mailing Address - Phone:907-543-3988
Mailing Address - Fax:907-543-5787
Practice Address - Street 1:127 ATSAQ STREET
Practice Address - Street 2:127 ATSAQ
Practice Address - City:BETHEL
Practice Address - State:AK
Practice Address - Zip Code:99559-0927
Practice Address - Country:US
Practice Address - Phone:907-543-3988
Practice Address - Fax:907-543-5787
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-18
Last Update Date:2012-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK974445261QA0600X, 343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)