NPI Record of COHO (COMMUNITIES ORGANIZED FOR HEALTH OPTIONS) NPI 1609906635

Community/Behavioral Health in Craig, AK

Complete NPI Record

Field Name Value Definition
NPI1609906635The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
Entity Type Code2Code describing the type of health care provider that is being assigned an NPI. 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 (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
Employer Identification Number EINUNAVAILThe Employer Identification Number (EIN), assigned by the IRS, of the provider being identified.
Provider Organization Name Legal Business NameCOMMUNITIES ORGANIZED FOR HEALTH OPTIONSThe name of the organization provider. If the provider is an organization, this is the legal business name.
Provider Other Organization NameCOHOOther name by which the organization provider is or has been known.
Provider Other Organization Name Type Code5Code identifying the type of other 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 First Line Business Mailing AddressPO BOX 805The first line mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider first line location address’’.
Provider Business Mailing Address City NameCRAIGThe city name in the mailing address of the provider being identified.
Provider Business Mailing Address State NameAKThe State or Province name in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address State name’’.
Provider Business Mailing Address Postal Code999210805The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as ‘‘Provider location address postal code’’.
Provider Business Mailing Address Country Code If outside U S USThe country code in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address country code’’.
Provider Business Mailing Address Telephone Number9078263662The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address telephone number’’.
Provider Business Mailing Address Fax Number9078262917The fax number associated with the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address fax number’’.
Provider First Line Business Practice Location Address210 COLD STORAGE ROADThe first line 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 Business Practice Location Address City NameCRAIGThe city name in the location address of the provider being identified.
Provider Business Practice Location Address State NameAKThe State code in the location of the provider being identified.
Provider Business Practice Location Address Postal Code999210805The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Country Code If outside U S USThe country code in the location address of the provider being identified.
Provider Business Practice Location Address Telephone Number9078263662The telephone number associated with the location address of the provider being identified.
Provider Business Practice Location Address Fax Number9078262917The fax number associated with the location address of the provider being identified.
Provider Enumeration Date3/7/2007The date the provider was assigned a unique identifier (assigned an NPI).
Last Update Date8/22/2020The date that a record was last updated or changed.
Authorized Official Last NameVEITThe last name of the person authorized to submit the NPI application or to change NPS data for a health care provider.
Authorized Official First NameDOUGThe first name of the authorized official.
Authorized Official Title or PositionCO-EXECUTIVE DIRECTORThe title or position of the authorized official.
Authorized Official Telephone Number9078263662The 10-position telephone number of the authorized official.
Healthcare Provider Taxonomy Code 1251S00000XCode designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
Provider License Number 183770The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with ‘‘provider taxonomy code’’.
Provider License Number State Code 1AKThe code representing the State that issued the license to the provider being identified. This field can accommodate multiple States. It is associated with ‘‘provider license number.
Healthcare Provider Primary Taxonomy Switch 1Y
Other Provider Identifier 1MH1878Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 105Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier State 1AK
Other Provider Identifier 2DY4818Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 205Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier State 2AK
Is Organization SubpartN
Authorized Official Name Prefix TextMR.
Authorized Official Credential TextLCSW