Provider Demographics
NPI:1952572927
Name:VIA VITA HEALTH PROJECT, INC.
Entity Type:Organization
Organization Name:VIA VITA HEALTH PROJECT, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DANA
Authorized Official - Middle Name:LOUISE
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:CDM
Authorized Official - Phone:907-456-3719
Mailing Address - Street 1:2054 30TH AVE
Mailing Address - Street 2:
Mailing Address - City:FAIRBANKS
Mailing Address - State:AK
Mailing Address - Zip Code:99701-7316
Mailing Address - Country:US
Mailing Address - Phone:907-456-3719
Mailing Address - Fax:
Practice Address - Street 1:2054 30TH AVE
Practice Address - Street 2:
Practice Address - City:FAIRBANKS
Practice Address - State:AK
Practice Address - Zip Code:99701-7316
Practice Address - Country:US
Practice Address - Phone:907-456-3719
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-18
Last Update Date:2017-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK261QB0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QB0400XAmbulatory Health Care FacilitiesClinic/CenterBirthing