Provider Demographics
NPI:1972120210
Name:DENALI FAMILY SERVICES
Entity type:Organization
Organization Name:DENALI FAMILY SERVICES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:PETER
Authorized Official - Middle Name:
Authorized Official - Last Name:HOUSTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:907-354-6308
Mailing Address - Street 1:291 E SWANSON AVE
Mailing Address - Street 2:
Mailing Address - City:WASILLA
Mailing Address - State:AK
Mailing Address - Zip Code:99654-7004
Mailing Address - Country:US
Mailing Address - Phone:907-376-3275
Mailing Address - Fax:
Practice Address - Street 1:291 E SWANSON AVE
Practice Address - Street 2:
Practice Address - City:WASILLA
Practice Address - State:AK
Practice Address - Zip Code:99654-7004
Practice Address - Country:US
Practice Address - Phone:907-376-3275
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DENALI FAMILY SERVICES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-07-02
Last Update Date:2023-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)