Organization
FAIRBANKS COMMUNITY MENTAL HEALTH SERVICES, LLC
Active
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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