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Behavioral Health & Social Service Providers Counselor Professional

Provider NPI: 1275743825

Organization Information:
Authorized Official:  RAY  DEPALATIS  SECRETARY - TREASURER  907-562-6418

Practice Location:
3150 C ST STE., 280 ANCHORAGE, AK 99503-3916 US
Tel: 907-562-6418  Fax: 907-563-8287

Business Mailing Address:
3150 C ST STE., 280 ANCHORAGE, AK 99503-3916 US
Tel: 907-562-6418  Fax: 907-563-8287

NPI Information:
NPI: 1275743825
Entity Type: Organization


PrimaryCodeCategory/DescriptionStateLicense Number
Y101YP2500XBehavioral Health & Social Service Providers

Other Provider Identifiers:


American Medical Association 2012 taxonomy code information

Code: 101YP2500X





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