Organization
THE SALVATION ARMY
Active
Other names
Booth Memorial Youth & Family Services
Organization subpart
No
Provider details
NPI number
Authorized official
MS. KELLY A EGGLESTON LPC (CLINICAL DIRECTOR)
(907) 375-3505
Entity
Organization
Contact information
Practice address
3600 E 20TH AVE, ANCHORAGE, AK 99508
(907) 375-3505
(907) 279-0522
Mailing address
143 9TH AVE, ANCHORAGE, AK 99501-3618
(907) 375-3505
(907) 279-0522
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
—
—
324500000X
Substance Abuse Rehabilitation Facility
—
—
3245S0500X
Children's Substance Abuse Rehabilitation Facility
—
AK
3245S0500X
Children's Substance Abuse Rehabilitation Facility
—
—
Other
Enumeration date
06/21/2012
Last updated
06/21/2012
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