Provider Demographics
NPI:1952595167
Name:NORTON SOUND HEALTH CORPORATION
Entity Type:Organization
Organization Name:NORTON SOUND HEALTH CORPORATION
Other - Org Name:NORTON SOUND REGIONAL HOSPITAL
Other - Org Type:Other Name
Authorized Official - Title/Position:CLINICAL CARE COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:907-443-3344
Mailing Address - Street 1:711 EAST 3RD AVENUE
Mailing Address - Street 2:
Mailing Address - City:NOME
Mailing Address - State:AK
Mailing Address - Zip Code:99762
Mailing Address - Country:US
Mailing Address - Phone:907-443-4576
Mailing Address - Fax:907-443-5915
Practice Address - Street 1:306 WEST 5TH AVENUE
Practice Address - Street 2:
Practice Address - City:NOME
Practice Address - State:AK
Practice Address - Zip Code:99762
Practice Address - Country:US
Practice Address - Phone:907-443-3344
Practice Address - Fax:907-443-5915
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-30
Last Update Date:2007-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AKAK100247324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility