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Providence Kodiak Medical Center
Adult Care Home Facility in Kodiak, Alaska
NPI 1306147434

Providence Kodiak Medical Center is an Adult Care Home Facility based in Kodiak, AK and is specialized in Adult Care Home. Providence Kodiak Medical Center practices in Kodiak, AK. The NPI Number for Providence Kodiak Medical Center is 1306147434 and holds a License No. 31478 (Alaska).

The current practice location address for Providence Kodiak Medical Center is 1915 E Rezanof Dr, Kodiak, AK and can be reached out via phone at 907-486-3281 and via fax at 907-481-2497. You can also correspond with Providence Kodiak Medical Center through the mailing address at 1915 E REZANOF DR, KODIAK, AK - 99615-6602 (mailing address contact number: 907-486-3281).

Location: 1915 E Rezanof Dr, Kodiak, AK, 99615-6602
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1306147434
Provider Name
Providence Kodiak Medical Center
Credential
Provider Entity Type
Organization
Address
1915 E Rezanof Dr, Kodiak, AK, 99615-6602
Phone Number
907-486-3281
Fax Number
907-481-2497
Provider Enumeration Date
11/05/2010
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
1915 E Rezanof Dr
City
Kodiak
State
Alaska
Zip
99615-6602
Phone Number
907-486-3281
Fax Number
907-481-2497
person
Provider Business Mailing Address Details
Address
1915 E Rezanof Dr
City
Kodiak
State
Alaska
Zip
99615-6602
Phone Number
907-486-3281
Fax Number
907-481-2497
person
Provider's Taxonomy Details 1
Type
Nursing & Custodial Care Facilities
Classification
Custodial Care Facility
Speciality
Adult Care Home
Taxonomy
311ZA0620X
License No.
31478 (Alaska)
Definition
A custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like environment.
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