PRESBYTERIAN HOSPITALITY HOUSE NPI 1962619643

NPI Information

PRESBYTERIAN HOSPITALITY HOUSE is a residential treatment facility emotionally disturbed children in Fairbanks, AK. The provider is a residential facility that provides habilitation services and other care and treatment to children diagnosed with mental health illness, behavioral issues, and intellectual disabilities and are not able to live independently. PRESBYTERIAN HOSPITALITY HOUSE NPI is 1962619643. The provider is registered as an organization entity type.
The provider Other Name Is 7th Ave Home.

The provider's business location address is:

209 FORTY MILE AVE STE 100
FAIRBANKS, AK
ZIP 99701-110
Phone: (907) 456-6445
Fax: (907) 456-6402

The provider's authorized official is Drenda Tigner .
The authorized official title is Excutive Director and has the following contact phone number (907) 456-6445.

The enumeration date for this NPI number is 5/16/2007 and was last updated on 10/23/2008.

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:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

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