Provider Demographics
NPI:1558809285
Name:THE ARC OF ANCHORAGE
Entity type:Organization
Organization Name:THE ARC OF ANCHORAGE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:HR MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KIMBER
Authorized Official - Middle Name:
Authorized Official - Last Name:SANBORN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:907-777-0154
Mailing Address - Street 1:2211 ARCA DR
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99508-3462
Mailing Address - Country:US
Mailing Address - Phone:907-277-6677
Mailing Address - Fax:907-777-0360
Practice Address - Street 1:2210 ARCA DR #1
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-3462
Practice Address - Country:US
Practice Address - Phone:907-277-6677
Practice Address - Fax:907-777-0360
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THE ARC OF ANCHORAGE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-02-01
Last Update Date:2023-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AK1713287Medicaid