Organization Name: | EDGER NOLLNER HEALTH CENTER |
NPI Number: | 1134373640 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | KIM WOLF (FINANCE DIRECTOR) |
Mailing Address: | 77 Antoski Ave. Galena |
State: | AK US |
Postal Code: | 99741 |
Phone Number: | 9076562489 |
Fax Number: | 9076561769 |
NPI Enumeration Date: | 11/11/2008 |
NPI Last Update Date: | 11/11/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QR0405X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Rehabilitation, Substance Use Disorder |
Taxonomy Definition: |