Provider Demographics
NPI:1922212844
Name:ACCA, INC.
Entity Type:Organization
Organization Name:ACCA, INC.
Other - Org Name:ALASKA CENTER FOR CHILDREN & ADULTS
Other - Org Type:Other Name
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:E
Authorized Official - Last Name:KESSLER
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:907-456-4003
Mailing Address - Street 1:1020 BARNETTE ST
Mailing Address - Street 2:
Mailing Address - City:FAIRBANKS
Mailing Address - State:AK
Mailing Address - Zip Code:99701-4502
Mailing Address - Country:US
Mailing Address - Phone:907-456-4003
Mailing Address - Fax:907-456-6214
Practice Address - Street 1:1020 BARNETTE ST
Practice Address - Street 2:
Practice Address - City:FAIRBANKS
Practice Address - State:AK
Practice Address - Zip Code:99701-4502
Practice Address - Country:US
Practice Address - Phone:907-456-4003
Practice Address - Fax:907-456-6214
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-09
Last Update Date:2011-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
No251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKCMG264Medicaid
AKGR0141Medicaid
AK026512Medicare ID - Type Unspecified