NPIMap

Organization Active NPI

Alaskan Amazing Grace Alh LLC

  • Mental Health Counselor
  • Anchorage, AK
National Provider Identifier
1508616236
Registry record updated Mar 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
ALASKAN AMAZING GRACE ALH LLC
Practice address
4939 Folker St Unit a
Anchorage, AK 99507-1456
Phone
(907) 440-3000
NPI assigned
Mar 25, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2024

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

Authorized official

Name
Jerry FonsecaNPI 1568078830
Title
Owner/Administrator
Phone
(907) 440-3000

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

4939 Folker St Unit a
Anchorage, AK 99507-1456

Mailing address

4939 Folker St Unit a
Anchorage, AK 99507-1456
Phone (907) 440-3000

National Provider Directory

National Provider Directory

Locations

4939 Folker St
#A
Anchorage, AK 99507
Phone (907) 222-1725

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1711324800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1711324800000",
    "number": "1508616236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4939 FOLKER ST UNIT A",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995071456",
            "telephone_number": "907-440-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4939 FOLKER ST UNIT A",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995071456",
            "telephone_number": "907-440-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALASKAN AMAZING GRACE ALH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-25",
        "last_updated": "2024-03-25",
        "certification_date": "2024-03-25",
        "status": "A",
        "authorized_official_last_name": "FONSECA",
        "authorized_official_first_name": "JERRY",
        "authorized_official_title_or_position": "OWNER/ADMINISTRATOR",
        "authorized_official_telephone_number": "907-440-3000"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anchorage, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2024; 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.