Fairbanks Resource Agency Inc | |
805 Airport Road Fairbanks AK 99701 | |
(907) 456-8901 | |
(907) 452-5171 |
Full Name | Fairbanks Resource Agency Inc |
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Speciality | Community/behavioral Health |
Location | 805 Airport Road, Fairbanks, Alaska |
Authorized Official Name and Position | Emily Faye Ennis (EXECUTIVE DIRECTOR) |
Authorized Official Contact | 9074568901 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Fairbanks Resource Agency Inc 805 Airport Road Fairbanks AK 99701 Ph: (907) 456-8901 | Fairbanks Resource Agency Inc 805 Airport Road Fairbanks AK 99701 Ph: (907) 456-8901 |
NPI Number | 1912079088 |
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Provider Enumeration Date | 11/14/2006 |
Last Update Date | 08/22/2020 |
Identifier | Type | State | Issuer |
---|---|---|---|
1912079088 | NPI | - | NPPES |
HC5250 | Medicaid | AK |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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