Provider Demographics
NPI:1285272229
Name:ANCHORAGE COMMUNITY MENTAL HEALTH SERVICES, INC
Entity type:Organization
Organization Name:ANCHORAGE COMMUNITY MENTAL HEALTH SERVICES, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:EVENSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:907-261-5317
Mailing Address - Street 1:4020 FOLKER ST
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99508-5321
Mailing Address - Country:US
Mailing Address - Phone:907-563-1000
Mailing Address - Fax:907-375-3142
Practice Address - Street 1:1450 MULDOON RD
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99504-2820
Practice Address - Country:US
Practice Address - Phone:907-563-1000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ANCHORAGE COMMUNITY MENTAL HEALTH SERVICES, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-12-19
Last Update Date:2021-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKK0000WCGNGOtherMEDICARE