Provider Demographics
NPI:1457508459
Name:GENERATIONS A FAMILY PLACE INC
Entity Type:Organization
Organization Name:GENERATIONS A FAMILY PLACE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ALLEN
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:LEVY
Authorized Official - Suffix:
Authorized Official - Credentials:MS LPA
Authorized Official - Phone:907-222-4954
Mailing Address - Street 1:PO BOX 90941
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99509-0941
Mailing Address - Country:US
Mailing Address - Phone:907-222-4954
Mailing Address - Fax:907-222-7862
Practice Address - Street 1:500 W 27TH AVE STE C-2
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99503-2533
Practice Address - Country:US
Practice Address - Phone:907-222-4954
Practice Address - Fax:907-222-7862
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-20
Last Update Date:2008-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK548101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty