Provider Demographics
NPI:1164563383
Name:LYNN CANAL HUMAN RESOURCES, INC.
Entity Type:Organization
Organization Name:LYNN CANAL HUMAN RESOURCES, INC.
Other - Org Name:LYNN CANAL COUNSELING SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BUSINESS ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:BECKIE
Authorized Official - Middle Name:J
Authorized Official - Last Name:CHAPIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:907-766-2177
Mailing Address - Street 1:PO BOX 90
Mailing Address - Street 2:
Mailing Address - City:HAINES
Mailing Address - State:AK
Mailing Address - Zip Code:99827-0090
Mailing Address - Country:US
Mailing Address - Phone:907-766-2177
Mailing Address - Fax:907-766-2977
Practice Address - Street 1:215 WILLARD STREET
Practice Address - Street 2:
Practice Address - City:HAINES
Practice Address - State:AK
Practice Address - Zip Code:99827-0090
Practice Address - Country:US
Practice Address - Phone:907-766-2177
Practice Address - Fax:907-766-2977
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-09
Last Update Date:2009-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKMH0507Medicaid
AKDA3798Medicaid