Provider Demographics
NPI:1164631032
Name:PROGRAMS FOR INFANTS & CHILDREN, INC.
Entity Type:Organization
Organization Name:PROGRAMS FOR INFANTS & CHILDREN, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:
Authorized Official - Last Name:SIMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:907-561-8060
Mailing Address - Street 1:3330 ARCTIC BLVD STE 101
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99503-4580
Mailing Address - Country:US
Mailing Address - Phone:907-561-8060
Mailing Address - Fax:907-563-3172
Practice Address - Street 1:3330 ARCTIC BLVD STE 101
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99503-4580
Practice Address - Country:US
Practice Address - Phone:907-561-8060
Practice Address - Fax:907-563-3172
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKCMG494Medicaid