Organization
MAT SU YOUTH HOUSING
Active
Organization
MAT SU YOUTH HOUSING
Active
Other names
My House
Organization subpart
No
Provider details
NPI number
Authorized official
KYRA MACKEY AAS, CDC 1, PSP III (ADMINISTRATIVE MANAGER)
(907) 830-0506
Entity
Organization
Contact information
Practice address
300 N WILLOW ST, WASILLA, AK 99654-7042
(907) 373-4358
Mailing address
300 N WILLOW ST, WASILLA, AK 99654-7042
(907) 373-4358
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1745121
—
AK
05
—
1761139
—
AK
Enumeration date
02/13/2024
Last updated
04/30/2026
Update your record
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