BOYS AND GIRLS HOME OF ALASKA (NPI# 1255631446) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255631446 |
| Entity Type | Organization |
| Organization Name | BOYS AND GIRLS HOME OF ALASKA |
| Practice Address |
3101 Lathrop St Fairbanks AK 99701-7426 |
| Practice Telephone | 7122934700 |
| Practice Fax Number | 7122934800 |
| Mailing Telephone | 7122934700 |
| Mailing Fax Number | 7122934800 |
| Enumeration Date | 2010-10-22 |
| Last Update Date | 2010-10-22 |
| Authorized Official Name | DR. RICHARD C BROWN JR. (MEDICAL DIRECTOR) |
| Authorized Official Telephone | 7122934700 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | Y |
| Parent Organization Name | BOYS AND GIRLS HOME AND FAMILY SERVICES, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320800000X | Community Based Residential Treatment Facility, Mental Illness | 513478 | AK | Residential Treatment Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457528366 | Boys and Girls Home of Alaska | Residential Treatment Facility, Emotionally Disturbed Children | 3101 Lathrop Street, Fairbanks, AK 99707-0870 | 2008-05-09 |
| 1225338189 | Boys and Girls Home of Alaska | Psychiatry & Neurology | 3101 Lathrop St, Fairbanks, AK 99701-7426 | 2010-10-26 |
| Street Address |
3101 LATHROP ST |
| City | FAIRBANKS |
| State | AK |
| Zip Code | 99701-7426 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609088491 | Ted Campbell | Counselor | 3101 Lathrop St, Fairbanks, AK 99701-7426 | 2007-05-04 |
| 1164029161 | Amanda Young | Behavior Technician | 3101 Lathrop St, Fairbanks, AK 99701-7426 | 2020-10-03 |
| 1699372623 | Iesha Nicole Little-robinson | Behavior Technician | 3101 Lathrop St, Fairbanks, AK 99701-7426 | 2020-10-02 |
| 1730786765 | Victor Ramon Pichardo Nunez | Behavior Technician | 3101 Lathrop St, Fairbanks, AK 99701-7426 | 2020-10-02 |
| 1467059493 | Alissa Merrily Allen | Behavior Technician | 3101 Lathrop St, Fairbanks, AK 99701-7426 | 2020-10-02 |
| 1053918078 | Abigail Scott | Behavior Technician | 3101 Lathrop St, Fairbanks, AK 99701-7426 | 2020-10-02 |
| 1326657412 | Eric Enlow | Behavior Technician | 3101 Lathrop St, Fairbanks, AK 99701-7426 | 2020-07-24 |
| 1659980746 | Alisha Gail | Behavior Technician | 3101 Lathrop St, Fairbanks, AK 99701-7426 | 2020-07-24 |
| 1467061564 | Anjoli D. Anderson | Behavior Technician | 3101 Lathrop St, Fairbanks, AK 99701-7426 | 2020-07-24 |
| 1609485796 | Brionna Leigh Yannello | Behavior Technician | 3101 Lathrop St, Fairbanks, AK 99701-7426 | 2020-07-24 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659984987 | Resource Center for Parents & Children, Inc. | Social Worker | 726 26th Ave, Suite #2, Fairbanks, AK 99701 | 2020-08-26 |
| 1134738982 | Aaron Paul Sarauer | Behavior Technician | 3121 Lathrop St., Fairbanks, AK 99701 | 2020-07-28 |
| 1437715505 | Fabienne Rose Marie Siddall | Case Manager/Care Coordinator | 122 1st Avenue, Fairbanks, AK 99701 | 2019-05-14 |
| 1902461957 | Jacqueline Marie Rahm | Counselor | Family Centered Services of Alaska - Rtc, 3101 Lathrop St., Fairbanks, AK 99701 | 2019-05-06 |
| 1821588989 | Corrie Wilson | Nurse Practitioner | 1025 Barnette Street, Fairbanks, AK 99701 | 2018-05-15 |
| 1922519305 | Sarishma Sangeeta Lal | Registered Nurse | 815 2nd Ave Ste 122, Fairbanks, AK 99701 | 2017-10-12 |
| 1245690569 | Christine L Simko | Naturopath | 1275 Sadler Way, Ste 100 Rm 147, Fairbanks, AK 99701 | 2016-02-29 |
| 1932581600 | Jennifer Davis | Registered Nurse | 1025 West Barnette St., Fairbanks, AK 99701 | 2015-06-18 |
| 1700272705 | John D. Zipperer Jr Md, LLC | Clinic/Center | 751 Old Richardson Hwy., Fairbanks, AK 99701 | 2015-04-07 |
| 1578957460 | Mara Justine Becker | Physician Assistant | 1717 W. Cowles St, Fairbanks, AK- ALASKA 99701 | 2015-03-27 |
| Find all providers in zip 99701 | ||||
| Taxonomy Code | 320800000X |
| Grouping | Residential Treatment Facilities |
| Classification | Community Based Residential Treatment Facility, Mental Illness |
| A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134408586 | Lynda Purvis | Community Based Residential Treatment Facility, Mental Illness | 117 1st Avenue, Fairbanks, AK 99701 | 2011-08-16 |
| 1467784140 | Tanana Chiefs Conference | Community Based Residential Treatment Facility, Mental Illness | 122 First Avenue 4th Floor, Fairbanks, AK 99701 | 2010-02-05 |
| 1154565133 | Tanana Chiefs Conference | Community Based Residential Treatment Facility, Mental Illness | 122 1st Ave Ste 4, Fairbanks, AK 99701-4871 | 2009-04-22 |
| 1124350624 | Tanana Chiefs Conference | Community Based Residential Treatment Facility, Mental Illness | 122 1st Ave, Suite 400, Fairbanks, AK 99701 | 2010-02-08 |
| 1194969626 | Tanana Chiefs Conference | Community Based Residential Treatment Facility, Mental Illness | 122 1st Ave Ste 4, Fairbanks, AK 99701-4871 | 2009-04-28 |
| 1831332014 | Tanana Chiefs Conference | Community Based Residential Treatment Facility, Mental Illness | 122 1st Ave, 4th Fl, Fairbanks, AK 99701-4803 | 2009-04-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477802197 | Aldergrove Assisted Living | Community Based Residential Treatment Facility, Mental Illness | 41045 Denny Lane, Homer, AK 99603 | 2012-09-10 |
| 1114223476 | J.c Faith Open Arms #2 | Community Based Residential Treatment Facility, Mental Illness | 8301 E 11th Ct Unit 2, Anchorage, AK 99504-2210 | 2011-02-04 |
| 1689820979 | Akeela Inc | Community Based Residential Treatment Facility, Mental Illness | 3050 Fifth Ave, Ketchikan, AK 99901 | 2008-08-18 |
| 1790997922 | Helping Hands Alh Inc. | Community Based Residential Treatment Facility, Mental Illness | 1311 W 40th Ave, Anchorage, AK 99503-6507 | 2007-05-03 |
| 1639102882 | Southcentral Foundation | Community Based Residential Treatment Facility, Mental Illness | 4000 San Ernesto Ave, Anchorage, AK 99508-2874 | 2006-07-09 |
| 1700374550 | Sharon's Assisted Living, LLC | Community Based Residential Treatment Facility, Mental Illness | 1142 E 13th Ave, Anchorage, AK 99501-4739 | 2018-04-27 |
| 1184963225 | Peace and Harmony Alh | Community Based Residential Treatment Facility, Mental Illness | 107 Matthew Paul Way, Anchorage, AK 99504-4888 | 2013-02-09 |
| 1700086907 | Juneau Alliance for Mental Health, Inc | Community Based Residential Treatment Facility, Mental Illness | 3406 Glacier Hwy, Juneau, AK 99801-9501 | 2007-07-25 |
| 1619177813 | Juneau Alliance for Mental Health Inc | Community Based Residential Treatment Facility, Mental Illness | 3406 Glacier Hwy, Juneau, AK 99801-9501 | 2007-07-25 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.