# STATE OF ALASKA DEPARTMENT OF ADMINISTRATION

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- **Entity:** Organization
- **Status:** Active
- **Other names:** DHSS Offices of Children Services
- **Organization subpart:** No

## Provider details

- **NPI number:** 1467669150
- **Authorized official:** DAVE R NUGENT (ACCOUNTING TECHNICIAN II)
- **Authorized official phone:** (907) 465-5280

## Contact information

- **Practice address:** 130 SEWARD ST, SUITE 308, JUNEAU, AK 99801-2102
- **Practice address phone:** (907) 465-5280
- **Practice address fax:** (907) 465-3190
- **Mailing address:** PO BOX 110630, JUNEAU, AK 99811-0630
- **Mailing address phone:** (907) 465-5280
- **Mailing address fax:** (907) 465-3190

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 322D00000X | Emotionally Disturbed Childrens' Residential Treatment Facility | — | — | Yes |

## Other

- **Enumeration date:** 05/16/2007
- **Last updated:** 06/26/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | BR0021 | — | AK |