Provider Demographics
NPI:1255585360
Name:NSHC UNALAKLEET SUBREGIONAL CLINIC
Entity type:Organization
Organization Name:NSHC UNALAKLEET SUBREGIONAL CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUDIOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:LISA
Authorized Official - Middle Name:M
Authorized Official - Last Name:MAGES-HASKINS
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:907-624-3535
Mailing Address - Street 1:PO BOX 189
Mailing Address - Street 2:
Mailing Address - City:UNALAKLEET
Mailing Address - State:AK
Mailing Address - Zip Code:99684-0189
Mailing Address - Country:US
Mailing Address - Phone:907-624-3535
Mailing Address - Fax:907-624-3120
Practice Address - Street 1:189 HAPPY VALLEY RD
Practice Address - Street 2:
Practice Address - City:UNALAKLEET
Practice Address - State:AK
Practice Address - Zip Code:99684-0189
Practice Address - Country:US
Practice Address - Phone:907-624-3535
Practice Address - Fax:907-624-3120
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NORTON SOUND HEALTH CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-11-17
Last Update Date:2008-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK101282NR1301X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NR1301XHospitalsGeneral Acute Care HospitalRural