MANIILAQ RECOVERY CENTER (MANIILAQ ASSOCIATION) NPI 1003005828

Substance Abuse Rehabilitation Facility in Kotzebue, AK

NPI 1003005828 Organization Substance Abuse Rehabilitation Facility

About MANIILAQ RECOVERY CENTER (MANIILAQ ASSOCIATION)

Maniilaq Recovery Center (maniilaq Association) is a provider established in Kotzebue, Alaska specializing in substance abuse rehabilitation facility. The NPI number of Maniilaq Recovery Center (maniilaq Association) is 1003005828 and was assigned on October 2007. The practitioner's primary taxonomy code is 324500000X. The provider is registered as an organization and their NPI record was last updated 14 years ago. The provider's is doing business as Maniilaq Recovery Center. The authorized official of this NPI record is Mr. Rocio Baquerizo (Deputy Director)

NPI

1003005828

Provider NameMANIILAQ RECOVERY CENTER (MANIILAQ ASSOCIATION)
Provider Location Address722 SECOND AVE KOTZEBUE, AK 99752
Provider Mailing Address722 SECOND AVE KOTZEBUE, AK 99752
NPI Entity TypeOrganization
Is Sole Proprietor?N/A
Is Organization Subpart?No
Other Organization NameMANIILAQ RECOVERY CENTER
Other Name TypeDoing Business As (3)
Enumeration Date10-17-2007
Last Update Date10-17-2007


Primary Taxonomy

Taxonomy Code324500000X
ClassificationSubstance Abuse Rehabilitation Facility
TypeResidential Treatment Facilities
License StateAK
Taxonomy DescriptionA facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances.

Business Address

MANIILAQ RECOVERY CENTER
722 SECOND AVE
KOTZEBUE, AK
ZIP 99752
Phone: (907) 442-7640
Fax: (907) 442-7822

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Mailing Address

MANIILAQ RECOVERY CENTER
722 SECOND AVE
KOTZEBUE, AK
ZIP 99752
Phone: (907) 442-7640
Fax: (907) 442-7822



Authorized Official

Authorized Official NameMR. ROCIO BAQUERIZO
Authorized Official TitleDEPUTY DIRECTOR
Authorized Official Phone(907) 442-7640

Secondary Taxonomies


The secondary taxonomy codes define the provider type, classification, and specialization. For individual NPIs the license data is associated to each taxonomy code.

No. Taxonomy Code Type Classification Specialization License No. State Primary
1324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation FacilityNo

Taxonomy Description: a facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances.

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.