Provider Demographics
NPI:1669093837
Name:TRIBAL GOVERNMENT OF ST. PAUL ISLAND
Entity type:Organization
Organization Name:TRIBAL GOVERNMENT OF ST. PAUL ISLAND
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CHARLENE
Authorized Official - Middle Name:
Authorized Official - Last Name:NAULTY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:907-546-3200
Mailing Address - Street 1:PO BOX 86
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL ISLAND
Mailing Address - State:AK
Mailing Address - Zip Code:99660-0086
Mailing Address - Country:US
Mailing Address - Phone:907-546-3200
Mailing Address - Fax:
Practice Address - Street 1:1000 POLOVINA TURNPIKE
Practice Address - Street 2:
Practice Address - City:ST. PAUL ISLAND
Practice Address - State:AK
Practice Address - Zip Code:99660
Practice Address - Country:US
Practice Address - Phone:907-546-8301
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-29
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty
No174200000XOther Service ProvidersMeals
No177F00000XOther Service ProvidersLodging
No251300000XAgenciesLocal Education Agency (LEA)
No251B00000XAgenciesCase Management
No251E00000XAgenciesHome Health
No251K00000XAgenciesPublic Health or Welfare
No251S00000XAgenciesCommunity/Behavioral Health
No253J00000XAgenciesFoster Care Agency