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Organization
PRESBYTERIAN HOSPITALITY HOUSE
Active
Organization
PRESBYTERIAN HOSPITALITY HOUSE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DRENDA M TIGNER (EXCUTIVE DIRECTOR)
(907) 456-6445
Entity
Organization
Contact information
Practice address
209 FORTY MILE AVE, FAIRBANKS, AK 99701-3110
(907) 456-6445
(907) 456-6402
Mailing address
209 FORTY MILE AVE, FAIRBANKS, AK 99701-3110
(907) 456-6445
(907) 456-6402
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
—
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
MH2770
—
AK
Enumeration date
03/07/2007
Last updated
11/01/2012
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