Provider Demographics
NPI:1578732590
Name:ALASKA HUMAN SERVICES, INC.
Entity Type:Organization
Organization Name:ALASKA HUMAN SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:LANE
Authorized Official - Suffix:JR
Authorized Official - Credentials:PHD PSYCHOLOGY
Authorized Official - Phone:907-561-4535
Mailing Address - Street 1:PO BOX 230215
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99523-0215
Mailing Address - Country:US
Mailing Address - Phone:907-561-4535
Mailing Address - Fax:907-563-4534
Practice Address - Street 1:750 E FIREWEED LN
Practice Address - Street 2:STE. 200
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99503-2813
Practice Address - Country:US
Practice Address - Phone:907-561-4535
Practice Address - Fax:907-563-4534
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-23
Last Update Date:2008-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK387 PSYCHOLOGIST251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health