Organization Name: | FAIRBANKS COMMUNITY MENTAL HEALTH SERVICES, LLC |
NPI Number: | 1023445871 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | DARCIE M SHAFFER (MEDICAL BILLING MANAGER) |
Mailing Address: | 3830 S Cushman St Fairbanks |
State: | AK US |
Postal Code: | 997017530 |
Phone Number: | 9074521575 |
Fax Number: | 9074555287 |
NPI Enumeration Date: | 10/10/2013 |
NPI Last Update Date: | 10/10/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QM0850X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Adult Mental Health |
Taxonomy Definition: | An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults. |