| The Salvation Army Booth Memorial Outpatient | |
|
3600 E 20th Ave Anchorage AK 99508-3416 | |
| (907) 279-0522 | |
| Not Available |
| Full Name | The Salvation Army Booth Memorial Outpatient |
|---|---|
| Speciality | Social Worker |
| Location | 3600 E 20th Ave, Anchorage, Alaska |
| Authorized Official Name and Position | Adelene M Kelly (DIVISIONAL FINANCE DIRECTOR) |
| Authorized Official Contact | 9073393406 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| The Salvation Army Booth Memorial Outpatient 143 E 9th Ave Anchorage AK 99501-3618 Ph: (907) 339-3406 | The Salvation Army Booth Memorial Outpatient 3600 E 20th Ave Anchorage AK 99508-3416 Ph: (907) 279-0522 |
| NPI Number | 1023232808 |
|---|---|
| Provider Enumeration Date | 04/12/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023232808 | NPI | - | NPPES |
| DA4468 | Medicaid | AK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | 11806 (Alaska) | Primary |
| 104100000X | Social Worker | 11806 (Alaska) | Primary |
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