Individual
JASON TYRELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
5731 RADCLIFF DR # 1, ANCHORAGE, AK 99504-3019
(907) 339-4859
(907) 331-0463
Mailing address
3844 HELVETIA DR, ANCHORAGE, AK 99508-5016
(860) 367-3763
(907) 331-0463
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
101559
AK
Other
Enumeration date
08/22/2023
Last updated
08/22/2023
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