Provider Demographics
NPI:1720335524
Name:ANCHORAGE COMMUNITY MENTAL HEALTH
Entity Type:Organization
Organization Name:ANCHORAGE COMMUNITY MENTAL HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL ASSOCIATE
Authorized Official - Prefix:MS
Authorized Official - First Name:MAGGIE
Authorized Official - Middle Name:ROBLES
Authorized Official - Last Name:TUAZON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:907-762-8662
Mailing Address - Street 1:4020 FOLKER ST
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99508-5321
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1000 E 4TH AVE
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99501-2716
Practice Address - Country:US
Practice Address - Phone:907-762-8699
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-10
Last Update Date:2012-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health