Basic Information
| Provider Information | |||||||||
| NPI: | 1033511431 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ILIULIUK FAMILY &HEALTH SERVICES, INC. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 454 | ||||||||
| Address2: | |||||||||
| City: | UNALASKA | ||||||||
| State: | AK | ||||||||
| PostalCode: | 996850454 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9075811202 | ||||||||
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| Practice Location | |||||||||
| Address1: | 34 LAVELLE CT. | ||||||||
| Address2: | ILIULIUK FAMILY AND HEALTH SERVICES, INC | ||||||||
| City: | UNALASKA | ||||||||
| State: | AK | ||||||||
| PostalCode: | 99685 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9075811202 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/17/2014 | ||||||||
| LastUpdateDate: | 09/17/2014 | ||||||||
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| AuthorizedOfficialLastName: | SCOTT | ||||||||
| AuthorizedOfficialFirstName: | EILEEN | ||||||||
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| AuthorizedOfficialTitleorPosition: | EXECUTIVE DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 9075811202 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MRS. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QH0100X | 1019 | AK | Y | Ambulatory Health Care Facilities | Clinic/Center | Health Service |
No ID Information.