Organization
FAIRBANKS RESOURCE AGENCY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. EMILY FAYE ENNIS (EXECUTIVE DIRECTOR)
(907) 456-8901
Entity
Organization
Contact information
Practice address
805 AIRPORT ROAD, FAIRBANKS, AK 99701
(907) 456-8901
(907) 452-5171
Mailing address
805 AIRPORT ROAD, FAIRBANKS, AK 99701
(907) 456-8901
(907) 452-5171
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
HC5250
—
AK
Enumeration date
11/14/2006
Last updated
08/22/2020
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