Provider Demographics
NPI:1659754075
Name:RURAL ALASKA COMMUNITY ACTION PROGRAM, INC.
Entity Type:Organization
Organization Name:RURAL ALASKA COMMUNITY ACTION PROGRAM, INC.
Other - Org Name:SUPPORTIVE HOUSING DIVISION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:HARDENBERGH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:907-865-7364
Mailing Address - Street 1:731 E 8TH AVE
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99501-3772
Mailing Address - Country:US
Mailing Address - Phone:907-279-2511
Mailing Address - Fax:907-278-2309
Practice Address - Street 1:120 N HOYT ST
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-1602
Practice Address - Country:US
Practice Address - Phone:907-279-7535
Practice Address - Fax:907-279-9428
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-02
Last Update Date:2015-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health