Organization
HOUSE OF TRANSFORMATIONS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ENI I MAVAEGA (LEAD CASE MANAGER)
(907) 297-8942
Entity
Organization
Contact information
Practice address
500 E TUDOR RD STE 220, ANCHORAGE, AK 99503-7377
(907) 333-2468
Mailing address
500 E TUDOR RD STE 220, ANCHORAGE, AK 99503-7377
(907) 333-2468
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
174200000X
Meals Provider
—
—
251B00000X
Case Management Agency
Primary
—
—
Other
Enumeration date
11/07/2019
Last updated
11/07/2019
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