Organization
FAIRBANKS COMMUNITY MENTAL HEALTH SERVICES, LLC
Active
Parent organization
ANCHORAGE COMMUNITY MENTAL HEALTH SERVICES, INC
Organization subpart
Yes
Provider details
NPI number
Legal business name
ANCHORAGE COMMUNITY MENTAL HEALTH SERVICES, INC
Authorized official
AMY MORROW (BILLING MANAGER)
(907) 762-2820
Entity
Organization
Contact information
Practice address
3830 S CUSHMAN ST, FAIRBANKS, AK 99701-7530
(907) 371-1300
(907) 770-8917
Mailing address
4020 FOLKER ST, ANCHORAGE, AK 99508-5321
(907) 561-1000
(907) 770-8917
Taxonomy
Speciality
Code
Description
License number
State
103TP0016X
Prescribing (Medical) Psychologist
Primary
—
—
103TR0400X
Rehabilitation Psychologist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
K165350
MEDICARE
AK
Enumeration date
07/20/2015
Last updated
07/20/2015
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