| Tribal- Child & Family Outpatient Services(west) | |
|
3000 C St Ste 102 Anchorage AK 99503-3975 | |
| (907) 729-8558 | |
| Not Available |
| Full Name | Tribal- Child & Family Outpatient Services(west) |
|---|---|
| Speciality | Clinic/center - Multi-specialty |
| Location | 3000 C St Ste 102, Anchorage, Alaska |
| Authorized Official Name and Position | Ronald Lee Olson (EXECUTIVE VICE PRESIDENT FINANCE) |
| Authorized Official Contact | 9077294939 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Tribal- Child & Family Outpatient Services(west) Po Box 35198 Seattle WA 98124-5198 Ph: () - | Tribal- Child & Family Outpatient Services(west) 3000 C St Ste 102 Anchorage AK 99503-3975 Ph: (907) 729-8558 |
| NPI Number | 1043982671 |
|---|---|
| Provider Enumeration Date | 10/01/2021 |
| Last Update Date | 09/19/2023 |
| Certification Date | 09/19/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043982671 | NPI | - | NPPES |
| 1737238 | Medicaid | AK | |
| 1727040 | Medicaid | AK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Secondary |
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
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