Provider Demographics
NPI:1992422034
Name:ALASKA FAITH & FAMILY SERVICES
Entity type:Organization
Organization Name:ALASKA FAITH & FAMILY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CARE COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:RHODA
Authorized Official - Middle Name:
Authorized Official - Last Name:MYERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:907-301-2505
Mailing Address - Street 1:PO BOX 1177
Mailing Address - Street 2:
Mailing Address - City:CHICKALOON
Mailing Address - State:AK
Mailing Address - Zip Code:99674-1177
Mailing Address - Country:US
Mailing Address - Phone:907-301-2505
Mailing Address - Fax:888-677-2715
Practice Address - Street 1:38922 N GLENN HWY
Practice Address - Street 2:
Practice Address - City:SUTTON
Practice Address - State:AK
Practice Address - Zip Code:99674-8008
Practice Address - Country:US
Practice Address - Phone:907-301-2505
Practice Address - Fax:888-677-2715
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-19
Last Update Date:2023-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AK1681014Medicaid
AK1681018Medicaid