Healthcare Provider Details

I. General information

NPI: 1689820979
Provider Name (Legal Business Name): AKEELA INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/18/2008
Last Update Date: 07/02/2024
Certification Date: 07/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3050 FIFTH AVE
KETCHIKAN AK
99901
US

IV. Provider business mailing address

360 W BENSON BLVD STE 300
ANCHORAGE AK
99503-3953
US

V. Phone/Fax

Practice location:
  • Phone: 907-225-4135
  • Fax: 907-258-6052
Mailing address:
  • Phone: 907-565-1200
  • Fax: 907-258-6052

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QC1500X
TaxonomyCommunity Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code320800000X
TaxonomyMental Illness Community Based Residential Treatment Facility
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State
# 6
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number942384
License Number StateAK

VIII. Authorized Official

Name: COURTNEY DONOVAN
Title or Position: CEO
Credential:
Phone: 907-433-7040