NPIMap

Organization Active NPI

Alaska Island Community Services

  • Developmental Disabilities Clinic/Center
  • Wrangell, AK
National Provider Identifier
1841497815
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmental Disabilities Clinic/CenterTaxonomy code 261QD1600X
Legal business name
ALASKA ISLAND COMMUNITY SERVICES
Practice address
333 Church St
Wrangell, AK 99929-1231
Phone
(907) 874-2373
Fax
(907) 874-2576
NPI assigned
Jul 2, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mark T Walker, LCSW
Title
Executive Director
Phone
(907) 874-2373

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Developmental Disabilities Clinic/Center 261QD1600X Primary

Addresses

Primary practice location

333 Church St
Wrangell, AK 99929-1231

Mailing address

PO Box 1231
Wrangell, AK 99929-1231
Phone (907) 874-2373

Other identifiers 1

IdentifierTypeStateIssuer
HC9543MedicaidAK

National Provider Directory

National Provider Directory
Tax ID family
Alaska Island Community Services6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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": "1183334400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1841497815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1231",
            "city": "WRANGELL",
            "state": "AK",
            "postal_code": "999291231",
            "telephone_number": "907-874-2373",
            "fax_number": "907-874-2576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 CHURCH ST",
            "city": "WRANGELL",
            "state": "AK",
            "postal_code": "999291231",
            "telephone_number": "907-874-2373",
            "fax_number": "907-874-2576"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALASKA ISLAND COMMUNITY SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-02",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WALKER",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "907-874-2373",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "261QD1600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "HC9543",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wrangell, AK

Sources for this page

  • 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.