Provider Demographics
NPI:1376620179
Name:FAMILY OUTREACH CENTER FOR UNDERSTANDING SPECIAL NEEDS INC
Entity Type:Organization
Organization Name:FAMILY OUTREACH CENTER FOR UNDERSTANDING SPECIAL NEEDS INC
Other - Org Name:FOCUS INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:QUALITY ASSURANCE
Authorized Official - Prefix:
Authorized Official - First Name:DIXI
Authorized Official - Middle Name:
Authorized Official - Last Name:AMIDON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:907-694-6002
Mailing Address - Street 1:16635 CENTERFIELD DR STE 103
Mailing Address - Street 2:
Mailing Address - City:EAGLE RIVER
Mailing Address - State:AK
Mailing Address - Zip Code:99577-7745
Mailing Address - Country:US
Mailing Address - Phone:907-694-6002
Mailing Address - Fax:907-694-6015
Practice Address - Street 1:16635 CENTERFIELD DR STE 103
Practice Address - Street 2:
Practice Address - City:EAGLE RIVER
Practice Address - State:AK
Practice Address - Zip Code:99577-7745
Practice Address - Country:US
Practice Address - Phone:907-694-6002
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2021-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKCMG121Medicaid
AKCMG621Medicaid
AKHC1621Medicaid
AKTC2162Medicaid