Provider Demographics
NPI:1275271769
Name:MARIKEET HOME HEALTH SERVICES OF ALASKA, LLC
Entity Type:Organization
Organization Name:MARIKEET HOME HEALTH SERVICES OF ALASKA, LLC
Other - Org Name:MARIKEET NURSING SERVICES
Other - Org Type:Other Name
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:
Authorized Official - Last Name:MCLANE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:907-252-7810
Mailing Address - Street 1:161 N BINKLEY ST STE 203
Mailing Address - Street 2:
Mailing Address - City:SOLDOTNA
Mailing Address - State:AK
Mailing Address - Zip Code:99669-7571
Mailing Address - Country:US
Mailing Address - Phone:907-252-7801
Mailing Address - Fax:907-771-9711
Practice Address - Street 1:161 N BINKLEY ST STE 203
Practice Address - Street 2:
Practice Address - City:SOLDOTNA
Practice Address - State:AK
Practice Address - Zip Code:99669-7571
Practice Address - Country:US
Practice Address - Phone:907-252-7801
Practice Address - Fax:907-771-9711
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-24
Last Update Date:2023-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AK1734275Medicaid