Healthcare Provider Details

I. General information

NPI: 1316702202
Provider Name (Legal Business Name): ALASKA HEALTH CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/19/2024
Last Update Date: 02/19/2024
Certification Date: 02/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8300 POKEY CIR
ANCHORAGE AK
99507-3233
US

IV. Provider business mailing address

8300 POKEY CIR
ANCHORAGE AK
99507-3233
US

V. Phone/Fax

Practice location:
  • Phone: 301-455-1776
  • Fax:
Mailing address:
  • Phone: 301-455-1776
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number StateNULL

VIII. Authorized Official

Name: ROCHELLE RENEE DIXON
Title or Position: CCO
Credential:
Phone: 301-455-1776