# DAVID N AMPONG

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** Alaska Treatment Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1104464460
- **Authorized official:** JENNIFER MCDERMOTT (CREDENTIALING SPECIALIST)
- **Authorized official phone:** (505) 712-2662

## Contact information

- **Practice address:** 1577 C ST STE 201, ANCHORAGE, AK 99501-5164
- **Practice address phone:** (907) 538-9958
- **Practice address fax:** (907) 865-2433
- **Mailing address:** 1577 C ST STE 201, ANCHORAGE, AK 99501-5164
- **Mailing address phone:** (907) 538-9958
- **Mailing address fax:** (907) 865-2433

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QR0405X | Substance Use Disorder Rehabilitation Clinic/Center | — | NULL | — |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 12/18/2019
- **Last updated:** 05/20/2025

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1701389 | — | AK |