NPIMap

Organization Active NPI

Boys and Girls Home of Alaska

  • Mental Illness Community Based Residential Treatment Facility
  • Fairbanks, AK
National Provider Identifier
1255631446
Registry record updated Oct 22, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X
License
513478 Issued in AK
Legal business name
BOYS AND GIRLS HOME OF ALASKA
Practice address
3101 Lathrop St
Fairbanks, AK 99701-7426
Phone
(712) 293-4700
Fax
(712) 293-4800
NPI assigned
Oct 22, 2010
Organization subpart
Yes
Parent organization
BOYS AND GIRLS HOME AND FAMILY SERVICES, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 22, 2010

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

Authorized official

Name
Dr. Richard C Brown Jr., M.D.
Title
Medical Director
Phone
(712) 293-4700

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Illness Community Based Residential Treatment Facility 320800000X 513478 AK Primary

Addresses

Primary practice location

3101 Lathrop St
Fairbanks, AK 99701-7426

Mailing address

3101 Lathrop St
Fairbanks, AK 99701-7426
Phone (712) 293-4700

National Provider Directory

National Provider Directory
Tax ID family
Boys and Girls Home of Alaska3 organizations share this tax ID, including this one
Part of
Boys and Girls Home and Family Services Inc

Other organizations with this tax ID 2

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

Locations

3101 Lathrop St
Fairbanks, AK 99701
Phone (907) 459-4700

NPI Registry JSON

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

{
    "created_epoch": "1287705600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1287705600000",
    "number": "1255631446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3101 LATHROP ST",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997017426",
            "telephone_number": "712-293-4700",
            "fax_number": "712-293-4800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3101 LATHROP ST",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997017426",
            "telephone_number": "712-293-4700",
            "fax_number": "712-293-4800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOYS AND GIRLS HOME OF ALASKA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BOYS AND GIRLS HOME AND FAMILY SERVICES, INC.",
        "enumeration_date": "2010-10-22",
        "last_updated": "2010-10-22",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "712-293-4700",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "AK",
            "license": "513478",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairbanks, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2010; 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.