Provider Demographics
NPI:1962625939
Name:NOME COMMUNITY CENTER, INC.
Entity type:Organization
Organization Name:NOME COMMUNITY CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DANIELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:SLINGSBY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:907-443-5259
Mailing Address - Street 1:P.O. BOX 98
Mailing Address - Street 2:
Mailing Address - City:NOME
Mailing Address - State:AK
Mailing Address - Zip Code:99762-0098
Mailing Address - Country:US
Mailing Address - Phone:907-443-5259
Mailing Address - Fax:907-443-2990
Practice Address - Street 1:505 WEST 3RD AVENUE
Practice Address - Street 2:
Practice Address - City:NOME
Practice Address - State:AK
Practice Address - Zip Code:99762
Practice Address - Country:US
Practice Address - Phone:907-443-5259
Practice Address - Fax:907-443-2990
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-10
Last Update Date:2015-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AKHC9475261QA0600X, 332U00000X, 261QA0600X
322D00000X, 322D00000X
AK60313008322D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
Yes322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children
No332U00000XSuppliersHome Delivered Meals
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKHC9475Medicaid
AKPCG104Medicaid
AK1585002Medicaid
AKCMG4751Medicaid