Fairbanks Resource Agency Inc

Primary specialty

Case Management AgencyTaxonomy code 251B00000X

Legal business name

FAIRBANKS RESOURCE AGENCY INC

Practice address

805 Airport Way
Fairbanks, AK 99701-6039

Phone

(907) 456-8901

Fax

(907) 452-5171

NPI assigned

Apr 20, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Emily F Ennis

Title

Executive Director

Phone

(907) 456-8901

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Fairbanks Resource Agency Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Fairbanks Resource Agency

  • Case Management Agency
  • Fairbanks, AK
  • NPI 1699003277
  NPD tax ID
• Fairbanks Resource Agency Inc

  • Community/Behavioral Health Agency
  • Fairbanks, AK
  • NPI 1912079088
  NPD tax ID

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1177027200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1205053006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "805 AIRPORT WAY",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997016039",
            "telephone_number": "907-456-8901",
            "fax_number": "907-452-5171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "805 AIRPORT WAY",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997016039",
            "telephone_number": "907-456-8901",
            "fax_number": "907-452-5171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAIRBANKS RESOURCE AGENCY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ENNIS",
        "authorized_official_first_name": "EMILY",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "907-456-8901",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "CMG 525",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Case Management Agency in Fairbanks, AK
• Providers in Fairbanks, AK by specialty
• Case Management Agency in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.