Organization
FAIRBANKS RESOURCE AGENCY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. EMILY F ENNIS (EXECUTIVE DIRECTOR)
(907) 456-8901
Entity
Organization
Contact information
Practice address
805 AIRPORT WAY, FAIRBANKS, AK 99701-6039
(907) 456-8901
(907) 452-5171
Mailing address
805 AIRPORT WAY, FAIRBANKS, AK 99701-6039
(907) 456-8901
(907) 452-5171
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
CMG 525
—
AK
Enumeration date
04/20/2007
Last updated
08/22/2020
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