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PEDIATRIC RESOURCE CENTER OF ALASKA NPI 1720600570


NPI Information

NPI: 1720600570
Provider Name: PEDIATRIC RESOURCE CENTER OF ALASKA
Classification: Community/Behavioral Health - 251S00000X
Entity Type: Organization
Address:
1975 W CHURCH RIDGE DR
WASILLA, AK
ZIP 99654
Phone: (907) 414-9554
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PEDIATRIC RESOURCE CENTER OF ALASKA is a community behavioral health in Wasilla, AK. The provider is a private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. PEDIATRIC RESOURCE CENTER OF ALASKA NPI is 1720600570. The provider is registered as an organization entity type.

The provider's business location address is:

1975 W CHURCH RIDGE DR
WASILLA, AK
ZIP 99654-102
Phone: (907) 414-9554

The provider's authorized official is Marshal Packa .
The authorized official title is Executive Manager and has the following contact phone number (907) 414-0203.

The enumeration date for this NPI number is 5/15/2020 and was last updated on 5/15/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1251S00000XCommunity/Behavioral HealthYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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