Kawerak Inc

Primary specialty

Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X

License

400297 Issued in AK

Legal business name

KAWERAK INC

Doing business as

Jacobs House

Practice address

407 K Street
Nome, AK 99762

Phone

(907) 443-8096

Fax

(907) 443-2708

NPI assigned

Apr 26, 2007

Last updated

Jul 8, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Loretta Bullard

Title

President

Phone

(907) 443-5231

Specialties & licenses 1

Addresses

Other names 1

• Jacobs House Doing business as

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

{
    "created_epoch": "1177545600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215475200000",
    "number": "1629298120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 948",
            "address_2": "P.O. BOX 948",
            "city": "NOME",
            "state": "AK",
            "postal_code": "997620948",
            "telephone_number": "907-443-8096",
            "fax_number": "907-443-2708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "407 K STREET",
            "city": "NOME",
            "state": "AK",
            "postal_code": "99762",
            "telephone_number": "907-443-8096",
            "fax_number": "907-443-2708"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KAWERAK INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-26",
        "last_updated": "2008-07-08",
        "status": "A",
        "authorized_official_last_name": "BULLARD",
        "authorized_official_first_name": "LORETTA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "907-443-5231",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "AK",
            "license": "400297",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jacobs House",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Isabelle Jackson
• Darlene E Jemewouk
• Aurora Johnson
• Helen Julia Archer Kahai, PSYD, EDD, LMHC
• Kamey Kapp, O.D.
• Mark W Kelso, DDS
• Renee Rose Kimaktoak, CHA-T
• Shannon Marie Klescewski
• Marilyn Koezuna-Irelan
• Geena Koonooka

• Emotionally Disturbed Childrens' Residential Treatment Facility in Nome, AK
• Providers in Nome, AK by specialty
• Emotionally Disturbed Childrens' Residential Treatment Facility in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2008; 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.