Organization
FAIRBANKS NATIVE ASSOCIATION
Active
Other names
Ralph Perdue Center
Organization subpart
No
Provider details
NPI number
Authorized official
GUY M PATTERSON (BHS DIRECTOR)
(907) 452-6251
Entity
Organization
Contact information
Practice address
3100 S CUSHMAN ST, FAIRBANKS, AK 99701-7516
(907) 452-6251
(907) 456-4849
Mailing address
605 HUGHES AVE, FAIRBANKS, AK 99701-7539
(907) 452-1648
(907) 456-4849
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
76821
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
DA4435
—
AK
Enumeration date
04/10/2008
Last updated
04/10/2008
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