NPIMap

Organization Active NPI

Yukon-Kuskokwim Health Corporation

  • Psychiatric Residential Treatment Facility
  • Bethel, AK
National Provider Identifier
1467679936
Registry record updated Jul 31, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric Residential Treatment FacilityTaxonomy code 323P00000X
Legal business name
YUKON-KUSKOKWIM HEALTH CORPORATION
Practice address
5016 Noel Polty Blvd.
Bethel, AK 99559
Phone
(907) 543-6800
Fax
(907) 543-7101
NPI assigned
Apr 19, 2007
Last updated
Jul 31, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Eugene R Peltola
Title
President & Ceo
Phone
(907) 543-6020

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Residential Treatment Facility 323P00000X NU Primary
Mental Health Counselor 101YM0800X NU

Addresses

Primary practice location

5016 Noel Polty Blvd.
Bethel, AK 99559

Mailing address

PO Box 528
Bethel, AK 99559-0528
Phone (907) 543-6000

Other identifiers 1

IdentifierTypeStateIssuer
HS414PIMedicaidAK

National Provider Directory

National Provider Directory
Tax ID family
Yukon-Kuskokwim HLTH Corp32 organizations share this tax ID, including this one

Other organizations with this tax ID 31

Organizations that report the same tax identification number in the National Provider Directory.

View all 31

Practitioners & affiliated clinicians

Practitioners 76

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 76

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1176940800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1375228800000",
    "number": "1467679936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 528",
            "city": "BETHEL",
            "state": "AK",
            "postal_code": "995590528",
            "telephone_number": "907-543-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5016 NOEL POLTY BLVD.",
            "city": "BETHEL",
            "state": "AK",
            "postal_code": "99559",
            "telephone_number": "907-543-6800",
            "fax_number": "907-543-7101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YUKON-KUSKOKWIM HEALTH CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-19",
        "last_updated": "2013-07-31",
        "status": "A",
        "authorized_official_last_name": "PELTOLA",
        "authorized_official_first_name": "EUGENE",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT & CEO",
        "authorized_official_telephone_number": "907-543-6020"
    },
    "taxonomies": [
        {
            "code": "323P00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Residential Treatment Facility",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "HS414PI",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bethel, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.