Organization
FAIRBANKS COMMUNITY MENTAL HEALTH SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ASHLEY EVENSON (BILLING MANAGER)
(907) 261-5317
Entity
Organization
Contact information
Practice address
1521 HILTON AVE, FAIRBANKS, AK 99701-4015
(907) 563-1000
Mailing address
4020 FOLKER ST, ANCHORAGE, AK 99508-5321
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1598661
—
AK
Enumeration date
09/28/2021
Last updated
09/28/2021
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