| Fairbanks Community Mental Health Services, Llc | |
|
1521 Hilton Ave Fairbanks AK 99701-4015 | |
| (907) 563-1000 | |
| Not Available |
| Full Name | Fairbanks Community Mental Health Services, Llc |
|---|---|
| Speciality | Counselor - Professional |
| Location | 1521 Hilton Ave, Fairbanks, Alaska |
| Authorized Official Name and Position | Ashley Evenson (BILLING MANAGER) |
| Authorized Official Contact | 9072615317 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Fairbanks Community Mental Health Services, Llc 4020 Folker St Anchorage AK 99508-5321 Ph: () - | Fairbanks Community Mental Health Services, Llc 1521 Hilton Ave Fairbanks AK 99701-4015 Ph: (907) 563-1000 |
| NPI Number | 1396417325 |
|---|---|
| Provider Enumeration Date | 09/28/2021 |
| Last Update Date | 09/28/2021 |
| Certification Date | 09/28/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396417325 | NPI | - | NPPES |
| 1598661 | Medicaid | AK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
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