Provider Demographics
NPI:1952947707
Name:ALASKA COMMUNITY TRAINING CENTER
Entity Type:Organization
Organization Name:ALASKA COMMUNITY TRAINING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:WEST
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:907-406-4132
Mailing Address - Street 1:PO BOX 672182
Mailing Address - Street 2:
Mailing Address - City:CHUGIAK
Mailing Address - State:AK
Mailing Address - Zip Code:99567-2182
Mailing Address - Country:US
Mailing Address - Phone:907-406-4132
Mailing Address - Fax:
Practice Address - Street 1:22245 WHISPERING BIRCH DR
Practice Address - Street 2:
Practice Address - City:CHUGIAK
Practice Address - State:AK
Practice Address - Zip Code:99567-5450
Practice Address - Country:US
Practice Address - Phone:907-406-4132
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-26
Last Update Date:2019-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services