Family Centered Services of Alaska
Organization Active NPI Counselor · Fairbanks, AK
NPI 1124445762 · NPPES record last updated Mar 20, 2014
Key facts
- NPI
- 1124445762
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Counselor 101Y00000X
- License
- 10Y00000X (AK)
- Legal business name
- FAMILY CENTERED SERVICES OF ALASKA
- Practice address
- 1825 Marika Rd
Fairbanks
Fairbanks, AK 99709-5521 - Phone
- (907) 474-0890
- NPI assigned
- Mar 20, 2014
- Organization subpart
- No
Authorized official
- Name
- Angelie Marie Lara
- Title
- Youth Counselor
- Phone
- (915) 731-5160
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor |
101Y00000X | 10Y00000X | AK | Yes |
Addresses
Primary practice location
1825 Marika Rd
Fairbanks
Fairbanks, AK 99709-5521
Mailing address
1825 Marika Rd
Fairbanks
Fairbanks, AK 99709-5521
Phone (907) 474-0890
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| MH3237 | Medicaid | AK |
Other providers in Fairbanks, AK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 20, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.