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Contact Information

PROVIDENCE HEALTH & SERVICES - WASHINGTON
3210 W 62ND AVE
ANCHORAGE, AK99502
 Phone: 907-212-2040
 Fax: 907-272-2169
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Psychiatric Residential Treatment Facility

323P00000X
Indicates primary specialty

NPI Profile & details for PROVIDENCE HEALTH & SERVICES - WASHINGTON

NPI Number 1659483113
LBN Legal business name PROVIDENCE HEALTH & SERVICES - WASHINGTON
Authorized official DONALD ANDERSON - (ASSISTANT SECRETARY OF ENROLLMENTS)
Entity Organization
Organization subpart 1 No
Enumeration date 08/31/2006
Last updated 05/15/2025 - More than a year ago
Identifiers
AK License # 400157
AK Medicaid HS487PI
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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