{
"Npi": {
"NPI": "1720309693",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "GASTINEAU HUMAN SERVICES CORPORATION",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "5597 AISEK ST",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "JUNEAU",
"MailingAddressStateName": "AK",
"MailingAddressPostalCode": "99801",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "907-780-3011",
"MailingAddressFaxNumber": "907-780-4098",
"FirstLinePracticeLocationAddress": "5590 AISEK STREET",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "JUNEAU",
"PracticeLocationAddressStateName": "AK",
"PracticeLocationAddressPostalCode": "99801",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "907-780-3011",
"PracticeLocationAddressFaxNumber": "907-780-4098",
"EnumerationDate": "06/15/2010",
"LastUpdateDate": "07/18/2025",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "KING",
"AuthorizedOfficialFirstName": "SYDNEY",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "BEHAVIORAL HEALTH OFFICE MANAGER",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "BS",
"AuthorizedOfficialTelephoneNumber": "907-780-3055",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "251S00000X",
"TaxonomyName": "Community/Behavioral Health Agency",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "324500000X",
"TaxonomyName": "Substance Abuse Rehabilitation Facility",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "101YA0400X",
"TaxonomyName": "Addiction (Substance Use Disorder) Counselor",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
}
}
}
}