Provider Demographics
NPI:1427360411
Name:STEP-IN AUTISM SERVICES OF ALASKA, L.L.C.
Entity Type:Organization
Organization Name:STEP-IN AUTISM SERVICES OF ALASKA, L.L.C.
Other - Org Name:STEP-IN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:ROBERTSON
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:907-455-6467
Mailing Address - Street 1:3568 GERAGHTY AVE
Mailing Address - Street 2:
Mailing Address - City:FAIRBANKS
Mailing Address - State:AK
Mailing Address - Zip Code:99709-4701
Mailing Address - Country:US
Mailing Address - Phone:907-374-7001
Mailing Address - Fax:907-374-7008
Practice Address - Street 1:3568 GERAGHTY AVE
Practice Address - Street 2:
Practice Address - City:FAIRBANKS
Practice Address - State:AK
Practice Address - Zip Code:99709-4701
Practice Address - Country:US
Practice Address - Phone:907-374-7001
Practice Address - Fax:907-374-7008
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-08
Last Update Date:2023-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AK1686065Medicaid