Organization Name: | SPIRIT SENT HEALTH CARE SERVICES, INC |
NPI Number: | 1306284781 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | BRENDA M SPOFFORD (PRESIDENT/CLINICIAN) |
Mailing Address: | 3819 Coumbine Circle Dillingham |
State: | AK US |
Postal Code: | 995760577 |
Phone Number: | 9078431966 |
Fax Number: | |
NPI Enumeration Date: | 06/07/2013 |
NPI Last Update Date: | 06/07/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QR1300X |
License Number: | 985585 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AK |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Rural Health |
Taxonomy Definition: |