NPIMap

Organization Active NPI

Presbyterian Hospitality House

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Fairbanks, AK
National Provider Identifier
1275754012
Registry record updated Nov 5, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X
Legal business name
PRESBYTERIAN HOSPITALITY HOUSE
Practice address
7609 Chena Hot Springs Rd
Fairbanks, AK 99712
Phone
(907) 456-6446
Fax
(907) 456-6402
NPI assigned
May 1, 2007
Last updated
Nov 5, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2012

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

Authorized official

Name
Drenda Tigner, MA
Title
Excutive Director
Phone
(907) 456-6445

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emotionally Disturbed Childrens' Residential Treatment Facility 322D00000X AK Primary

Addresses

Primary practice location

7609 Chena Hot Springs Rd
Fairbanks, AK 99712

Mailing address

209 Forty Mile Ave
Fairbanks, AK 99701-3110
Phone (907) 456-6446

Other identifiers 1

IdentifierTypeStateIssuer
MH2770MedicaidAK

Other names 1

  • Boys Farm Other name

National Provider Directory

National Provider Directory
Tax ID family
Presbyterian Hospitality House11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

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

NPI Registry JSON

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

{
    "created_epoch": "1177977600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1352073600000",
    "number": "1275754012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "209 FORTY MILE AVE",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997013110",
            "telephone_number": "907-456-6446",
            "fax_number": "907-456-6402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7609 CHENA HOT SPRINGS RD",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "99712",
            "telephone_number": "907-456-6446",
            "fax_number": "907-456-6402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRESBYTERIAN HOSPITALITY HOUSE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-01",
        "last_updated": "2012-11-05",
        "status": "A",
        "authorized_official_last_name": "TIGNER",
        "authorized_official_first_name": "DRENDA",
        "authorized_official_title_or_position": "EXCUTIVE DIRECTOR",
        "authorized_official_telephone_number": "907-456-6445",
        "authorized_official_credential": "MA"
    },
    "taxonomies": [
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "AK",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "MH2770",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Boys Farm",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 Nov 5, 2012; 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.