MEDICARE: RESILIENT YOUTH & COMMUNITY (RYC)

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1043836851
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RESILIENT YOUTH & COMMUNITY (RYC)

Provider Business Mailing Address
First Line	:	PO BOX 7475
Second Line	:
City	:	KETCHIKAN
State	:	AK
Zip	:	99901-2475
Country	:	US
Telephone Number	:	907-225-4664
Fax Number	:	907-885-6613

Provider Business Practice Location Address
First Line	:	2514 FIRST AVE
Second Line	:
City	:	KETCHIKAN
State	:	AK
Zip	:	99901-5804
Country	:	US
Telephone Number	:	907-225-4664
Fax Number	:	907-885-6613

Authorized Official
Title or Position	:	RYC CEO
Name	:	MR. DUSTIN ART LARNA
Credential	:
Telephone Number	:	907-220-7299

Provider Enumeration Date	:	06/18/2020
Last Update Date	:	06/03/2025

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Directions to “RESILIENT YOUTH & COMMUNITY (RYC) ” Practice Location

Language	Start Address	Practice Location

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