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NPI Code Detail

MEDICARE: FAMILY CENTERED SERVICES OF AK

MEDICARE: FAMILY CENTERED SERVICES OF AK
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1322D00000XEmotionally Disturbed Childrens' Residential Treatment Facility
2251S00000XCommunity/Behavioral Health Agency

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1417001942
Entity Type Code : Organization
Provider Name (Legal Business Name) : FAMILY CENTERED SERVICES OF AK
Provider Business Mailing Address
First Line : 1825 MARIKA RD
Second Line :
City : FAIRBANKS
State : AK
Zip : 99709-5521
Country : US
Telephone Number : 907-474-0890
Fax Number : 907-474-3621
Provider Business Practice Location Address
First Line : 1825 MARIKA RD
Second Line :
City : FAIRBANKS
State : AK
Zip : 99709-5521
Country : US
Telephone Number : 907-474-0890
Fax Number : 907-474-3621
Authorized Official
Title or Position : FINANCE OFFICER
Name : MRS. ALLISON J BENJAMIN
Credential :
Telephone Number : 907-474-0890
Provider Enumeration Date : 01/22/2007
Last Update Date : 10/29/2010

Similar Medicare Providers

1457946261 — JESSICA VARN LCSW
Practice Location Address:
1825 MARIKA RD
FAIRBANKS, AK
99709-5521
Practice Phone: 907-474-0890
Practice Fax:
1063603645 — CARL RAYBURN
Practice Location Address:
1825 MARIKA ROAD
FAIRBANKS, AK
99709-5521
Practice Phone: 907-455-1421
Practice Fax:
1033395512 — MRS. CANDACE ALEXIS BLACKWOOD MS
Practice Location Address:
1825 MARIKA RD
FAIRBANKS, AK
99709-5521
Practice Phone: 907-474-0890
Practice Fax: 907-451-8945
1174784862 — MRS. LESLIE RAE TESTER
Practice Location Address:
1825 MARIKA RD
FAIRBANKS, AK
99709-5521
Practice Phone: 907-474-0890
Practice Fax: 907-474-3621
1598921041 — HOLLY MCNAUGHTON WELLS LPC
Practice Location Address:
1825 MARIKA RD
FAIRBANKS, AK
99709-5521
Practice Phone: 907-479-4450
Practice Fax:
1548417371 — JULIA ANN SELID M.ED
Practice Location Address:
1825 MARIKA RD
FAIRBANKS, AK
99709-5521
Practice Phone: 907-374-2738
Practice Fax:

Directions to “FAMILY CENTERED SERVICES OF AK ” Practice Location

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