Organization
INTERIOR AIDS ASSOCIATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANNA NELSON (EXECUTIVE DIRECTOR)
(907) 452-4222
Entity
Organization
Contact information
Practice address
710 3RD AVENUE, FAIRBANKS, AK 99701-4455
(907) 452-4222
(907) 452-8176
Mailing address
P.O. BOX 71248, FAIRBANKS, AK 99707-1248
(907) 452-4222
(907) 452-8176
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
163WA0400X
Addiction (Substance Use Disorder) Registered Nurse
—
—
261QM2800X
Methadone Clinic
Primary
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1697598
—
AK
Enumeration date
12/04/2019
Last updated
12/04/2019
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