Provider Demographics
NPI:1184259855
Name:ALASKA YOUTH AND FAMILY NETWORK
Entity type:Organization
Organization Name:ALASKA YOUTH AND FAMILY NETWORK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATIONS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ALICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:CORNILS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:907-770-4979
Mailing Address - Street 1:PO BOX 233142
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99523-3142
Mailing Address - Country:US
Mailing Address - Phone:907-770-4979
Mailing Address - Fax:907-770-4979
Practice Address - Street 1:740 COMMUNICATIONS AVE
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99503-6000
Practice Address - Country:US
Practice Address - Phone:907-770-4979
Practice Address - Fax:907-770-4997
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-03
Last Update Date:2020-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health