NPIMap

Organization Active NPI

Denali Family Services

Doing business as 1115 Waiver Valley

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Wasilla, AK
National Provider Identifier
1972120210
Registry record updated Mar 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
DENALI FAMILY SERVICES
Doing business as
1115 Waiver Valley
Practice address
291 E Swanson Ave
Wasilla, AK 99654-7004
Phone
(907) 376-3275
NPI assigned
Jul 2, 2020
Last updated
Mar 23, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
DENALI FAMILY SERVICESAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 23, 2023

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

Authorized official

Name
Peter Houston
Title
Director of Operations
Phone
(907) 354-6308

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

291 E Swanson Ave
Wasilla, AK 99654-7004

Mailing address

291 E Swanson Ave
Wasilla, AK 99654-7004
Phone (907) 376-3275

Other names 2

  • 1115 Waiver Valley Doing business as
  • Denali Family Services- Wasilla Other name

National Provider Directory

National Provider Directory
Tax ID family
Denali Family Services2 organizations share this tax ID, including this one
Part of
Denali Family Services

Other organizations with this tax ID 1

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

Locations

291 E Swanson Ave
Wasilla, AK 99654
Phone (907) 274-8281

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 42

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 42

NPI Registry JSON

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

{
    "created_epoch": "1593648000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1679529600000",
    "number": "1972120210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "291 E SWANSON AVE",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996547004",
            "telephone_number": "907-376-3275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "291 E SWANSON AVE",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996547004",
            "telephone_number": "907-376-3275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENALI FAMILY SERVICES",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DENALI FAMILY SERVICES",
        "enumeration_date": "2020-07-02",
        "last_updated": "2023-03-23",
        "certification_date": "2023-03-23",
        "status": "A",
        "authorized_official_last_name": "HOUSTON",
        "authorized_official_first_name": "PETER",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "907-354-6308"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "1115 Waiver Valley",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Denali Family Services- Wasilla",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Denali Family Services- Wasilla",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Wasilla, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2023; 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.