Provider Demographics
NPI:1790024172
Name:MENTAL HEALTH SERVICES
Entity Type:Organization
Organization Name:MENTAL HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL ASSOCIATE COMMUNITY CONNEC
Authorized Official - Prefix:
Authorized Official - First Name:JOEL
Authorized Official - Middle Name:ANDREW
Authorized Official - Last Name:RIOJAS
Authorized Official - Suffix:
Authorized Official - Credentials:BACHELORS
Authorized Official - Phone:815-545-5862
Mailing Address - Street 1:4001 PIPER ST UNIT B
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99508-5434
Mailing Address - Country:US
Mailing Address - Phone:815-545-5862
Mailing Address - Fax:
Practice Address - Street 1:4001 PIPER ST UNIT B
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-5434
Practice Address - Country:US
Practice Address - Phone:815-545-5862
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-05
Last Update Date:2013-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management