Catholic Community Service
Organization Active NPI Meals Provider · Ketchikan, AK
NPI 1013035302 · NPPES record last updated Mar 30, 2021
Key facts
- NPI
- 1013035302
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Meals Provider 174200000X
- Legal business name
- CATHOLIC COMMUNITY SERVICE
- Practice address
- 1016 Water St
Ketchikan, AK 99901-6147 - Phone
- (907) 463-6149
- NPI assigned
- Mar 26, 2007
- Organization subpart
- No
Authorized official
- Name
- Jennifer Carson
- Title
- Director of HHCJ/ Compliance
- Phone
- (907) 463-6162
Corporate family (same tax ID) 14
Practitioners 2
National Provider Directory
- Tax ID family
- Catholic Community Service
Locations
1016 Water St
Ketchikan, AK 99901
Phone (907) 225-8080
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Meals Provider | 174200000X | Yes | ||
| Case Management Agency | 251B00000X |
Addresses
Primary practice location
1016 Water St
Ketchikan, AK 99901-6147
Mailing address
1803 Glacier Hwy
Juneau, AK 99801-7804
Phone (907) 463-6100
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1004614 | Medicaid | AK | |
| HC2652 | Medicaid | AK |
Other names
- KETCHIKAN SENIOR CENTER
Other providers in Ketchikan, AK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 30, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.