Organization
STATE OF ALASKA DEPARTMENT OF ADMINISTRATION
Active
Other names
DHSS Offices of Children Services
Organization subpart
No
Provider details
NPI number
Authorized official
DAVE R NUGENT (ACCOUNTING TECHNICIAN II)
(907) 465-5280
Entity
Organization
Contact information
Practice address
130 SEWARD ST, SUITE 308, JUNEAU, AK 99801-2102
(907) 465-5280
(907) 465-3190
Mailing address
PO BOX 110630, JUNEAU, AK 99811-0630
(907) 465-5280
(907) 465-3190
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
BR0021
—
AK
Enumeration date
05/16/2007
Last updated
06/26/2008
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