Organization
THE SALVATION ARMY BOOTH MEMORIAL OUTPATIENT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ADELENE M KELLY (DIVISIONAL FINANCE DIRECTOR)
(907) 339-3406
Entity
Organization
Contact information
Practice address
3600 E 20TH AVE, ANCHORAGE, AK 99508-3416
(907) 279-0522
Mailing address
143 E 9TH AVE, ANCHORAGE, AK 99501-3618
(907) 339-3406
(907) 276-2611
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
11806
AK
104100000X
Social Worker
Primary
11806
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
DA4468
—
AK
Enumeration date
04/12/2007
Last updated
09/11/2025
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