Provider Demographics
NPI:1336539535
Name:ALASKA COMMUNITY DEVELOPMENT CORPORATION
Entity Type:Organization
Organization Name:ALASKA COMMUNITY DEVELOPMENT CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:A
Authorized Official - Last Name:SHIFLEA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:907-746-5680
Mailing Address - Street 1:1517 S INDUSTRIAL WAY
Mailing Address - Street 2:#8
Mailing Address - City:PALMER
Mailing Address - State:AK
Mailing Address - Zip Code:99645-6791
Mailing Address - Country:US
Mailing Address - Phone:907-746-5680
Mailing Address - Fax:907-746-5681
Practice Address - Street 1:1517 S INDUSTRIAL WAY
Practice Address - Street 2:#8
Practice Address - City:PALMER
Practice Address - State:AK
Practice Address - Zip Code:99645-6791
Practice Address - Country:US
Practice Address - Phone:907-746-5680
Practice Address - Fax:907-746-5681
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-27
Last Update Date:2015-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK27403171WH0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171WH0202XOther Service ProvidersContractorHome ModificationsGroup - Single Specialty