Provider Demographics
NPI:1225769870
Name:YUKON COMMUNITY RECOVER SUPPORT SERVICES
Entity Type:Organization
Organization Name:YUKON COMMUNITY RECOVER SUPPORT SERVICES
Other - Org Name:YUKON EMPLOYMENT SOLUTIONS, INC
Other - Org Type:Other Name
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:PETER
Authorized Official - Middle Name:
Authorized Official - Last Name:IGWACHO
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, CDCS, LSATP,
Authorized Official - Phone:907-350-2326
Mailing Address - Street 1:3924 E 8TH AVE
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99508-2637
Mailing Address - Country:US
Mailing Address - Phone:907-350-2326
Mailing Address - Fax:
Practice Address - Street 1:3932 E 8TH AVE
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508
Practice Address - Country:US
Practice Address - Phone:907-350-2326
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-23
Last Update Date:2022-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoralGroup - Multi-Specialty
No251B00000XAgenciesCase ManagementGroup - Multi-Specialty