Healthcare Provider Details

I. General information

NPI: 1720309693
Provider Name (Legal Business Name): GASTINEAU HUMAN SERVICES CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/15/2010
Last Update Date: 07/18/2025
Certification Date: 07/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5590 AISEK STREET
JUNEAU AK
99801
US

IV. Provider business mailing address

5597 AISEK ST
JUNEAU AK
99801
US

V. Phone/Fax

Practice location:
  • Phone: 907-780-3011
  • Fax: 907-780-4098
Mailing address:
  • Phone: 907-780-3011
  • Fax: 907-780-4098

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State

VIII. Authorized Official

Name: SYDNEY KING
Title or Position: BEHAVIORAL HEALTH OFFICE MANAGER
Credential: BS
Phone: 907-780-3055