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Organization

THE SALVATION ARMY BOOTH MEMORIAL RESIDENTIAL CHILDCARE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ADELANE 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
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
11806
AK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
BR0005
AK
Enumeration date
04/13/2007
Last updated
08/22/2020
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