Healthcare Provider Details

I. General information

NPI: 1750929014
Provider Name (Legal Business Name): AKEELA INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/18/2019
Last Update Date: 12/18/2019
Certification Date: 12/18/2019
Deactivation Date:
Reactivation Date:

III. Provider practice location address

126 WASHINGTON ST
KETCHIKAN AK
99901-5954
US

IV. Provider business mailing address

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

V. Phone/Fax

Practice location:
  • Phone: 907-225-3510
  • Fax: 907-258-6052
Mailing address:
  • Phone: 907-565-1200
  • Fax: 907-258-6052

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State

VIII. Authorized Official

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