| Organization Name: | COOK INLET COUNCIL ON ALCOHOL AND DRUG ABUSE |
| NPI Number: | 1396897419 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | HENRY KRISTOFOR NOVAK (EXECUTIVE DIRECTOR) |
| Mailing Address: | 10200 Kenai Spur Hwy Kenai |
| State: | AK US |
| Postal Code: | 996117807 |
| Phone Number: | 9072833658 |
| Fax Number: | 9072835046 |
| NPI Enumeration Date: | 01/17/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QR0405X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AK |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Rehabilitation, Substance Use Disorder |
| Taxonomy Definition: | |