Organization
DAVID N AMPONG
Active
Other names
Alaska Treatment Center
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER MCDERMOTT (CREDENTIALING SPECIALIST)
(505) 712-2662
Entity
Organization
Contact information
Practice address
1577 C ST STE 201, ANCHORAGE, AK 99501-5164
(907) 538-9958
(907) 865-2433
Mailing address
1577 C ST STE 201, ANCHORAGE, AK 99501-5164
(907) 538-9958
(907) 865-2433
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1701389
—
AK
Enumeration date
12/18/2019
Last updated
05/20/2025
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