Branching Out Supported Services LLC

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

Legal business name

BRANCHING OUT SUPPORTED SERVICES LLC

Doing business as

Birch House

Practice address

1584 Hilton Ave
Fairbanks, AK 99701-4016

Phone

(907) 987-9267

NPI assigned

Oct 1, 2018

Organization subpart

No

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

Authorized official

Name

Mrs. Glenn Wrightsman

Title

Executive Director

Phone

(907) 987-9267

Specialties & licenses 2

Addresses

Other names 1

• Birch House Doing business as

Tax ID family

Branching Out Supported Services LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Branching Out Supported Services LLC

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Anchorage, AK
  • NPI 1538715164
  NPD tax ID

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

{
    "created_epoch": "1538352000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1783987200000",
    "number": "1942785464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1584 HILTON AVE",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997014016",
            "telephone_number": "907-987-9267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1584 HILTON AVE",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997014016",
            "telephone_number": "907-987-9267"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "806 Quasar Dr",
            "address_purpose": "LOCATION",
            "city": "Fairbanks",
            "state": "AK",
            "postal_code": "997122613",
            "country_code": "US",
            "telephone_number": "907-987-9267",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "BRANCHING OUT SUPPORTED SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-01",
        "last_updated": "2026-07-14",
        "certification_date": "2026-07-14",
        "status": "A",
        "authorized_official_last_name": "WRIGHTSMAN",
        "authorized_official_first_name": "GLENN",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "907-987-9267",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Birch House",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jennifer Susan Bracamontes, MD
• Caleb Brackett
• Kristin Ann Brooks Bradshaw, OTRL
• Rebecca Bradshaw, LMT
• John Brady, DMD
• Michelle D Brand
• Brigid Brandon, MA,CCC-SLP
• Naja Brandt
• Jason Brantley
• Dawn Brashear, LPC

• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Fairbanks, AK
• Providers in Fairbanks, AK by specialty
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2026; 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.