OrganizationActive
Professional Care Service
NPI 1508189945 · Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Anchorage, AK
Provider details
- NPI number
- 1508189945
- Entity type
- Organization
- Primary specialty
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityResidential Treatment Facilities
- Organization subpart
- No
- Authorized official
- Jessica Urena, Owned(907) 346-4410
- License
- 928682 (AK)
Specialties & taxonomies
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityPrimary320900000XLicense 928682 (AK)
Residential Treatment Facilities
Practice location
1743 Minerva Way
Same
Anchorage, AK 99515-1490
Phone: (907) 346-4410
Fax: (907) 346-4410
Approximate (ZIP-level) locationGet directions
Mailing address
1743 Minerva Way
Anchorage, AK 99515-1490
Registry dates
- Enumerated
- 2010-03-11
- Last updated
- 2010-03-11
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.