THE SALVATION ARMY BOOTH MEMORIAL RESIDENTIAL CHILDCARE (NPI# 1265656730) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265656730 |
| Entity Type | Organization |
| Organization Name | THE SALVATION ARMY BOOTH MEMORIAL RESIDENTIAL CHILDCARE |
| Practice Address |
3600 E 20th Ave Anchorage AK 99508-3416 |
| Mailing Address |
143 E 9th Ave Anchorage AK 99501-3618 |
| Practice Telephone | 9072790522 |
| Mailing Telephone | 9073393406 |
| Mailing Fax Number | 9072762611 |
| Enumeration Date | 2007-04-13 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | ADELANE M KELLY (DIVISIONAL FINANCE DIRECTOR) |
| Authorized Official Telephone | 9073393406 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 322D00000X | Residential Treatment Facility, Emotionally Disturbed Children | 11806 | AK | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AK | BR0005 | 05 |
| Street Address |
3600 E 20TH AVE |
| City | ANCHORAGE |
| State | AK |
| Zip Code | 99508-3416 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023232808 | The Salvation Army Booth Memorial Outpatient | Counselor | 3600 E 20th Ave, Anchorage, AK 99508-3416 | 2007-04-12 |
| 1801418785 | Tina Demelfi-warner | Counselor | 3600 E 20th Ave, Anchorage, AK 99508-3416 | 2020-05-13 |
| 1760044945 | Angel C Mcgowan | Counselor | 3600 E 20th Ave, Anchorage, AK 99508-3416 | 2019-07-08 |
| 1003478280 | Tere Lynn Turner | Counselor | 3600 E 20th Ave, Anchorage, AK 99508-3416 | 2019-07-08 |
| 1558923730 | Scott Craig Nicloy | Counselor | 3600 E 20th Ave, Anchorage, AK 99508-3416 | 2019-07-08 |
| 1902169253 | The Salvation Army | Residential Treatment Facility, Emotionally Disturbed Children | 3600 E 20th Ave, Anchorage, AK 99508 | 2012-06-21 |
| 1326262890 | The Salvation Army Booth Memorial Cares for Kids Nursery | Residential Treatment Facility, Emotionally Disturbed Children | 3600 E 20th Ave, Anchorage, AK 99508-3416 | 2007-04-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366063349 | Alexandra L Davis | Student in an Organized Health Care Education/Training Program | 1202 E 36th Ave, Anchorage, AK 99508 | 2020-05-01 |
| 1366087108 | The Salvation Army, A California Corporation | Community/Behavioral Health | 3600 East 20th Avenue, Anchorage, AK 99508 | 2019-11-15 |
| 1679120349 | Kila Gilcart | Speech-Language Pathologist | 161 Klevin Street #103, Anchorage, AK 99508 | 2019-08-19 |
| 1326692963 | Shannon Maillet | Behavior Technician | 1650 S Bragaw, Anchorage, AK 99508 | 2019-07-31 |
| 1427602044 | Frank Harris Lawson Iv | Behavior Technician | 1650 S. Bragaw, Anchorage, AK 99508 | 2019-07-31 |
| 1104470723 | Vivalesi Seforosa Nair | Behavior Technician | 1650 South Bragaw, Anchorage, AK 99508 | 2019-07-31 |
| 1043864267 | The Cozy Chalet Assisted Living Home LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 3707 Mt Blanc Circle, Anchorage, AK 99508 | 2019-07-25 |
| 1942861778 | Christine Mary Hoover | Registered Nurse | Alaska Native Medical Center - Inpatient Pediatrics, 4315 Diplomacy Dr, Anchorage, AK 99508 | 2019-06-24 |
| 1215594502 | Ashley Ongtowasruk | Case Manager/Care Coordinator | 4441 Dipomacy Dr, Suite 500, Anchorage, AK 99508 | 2019-05-22 |
| 1659937019 | Rayne Johnson | Behavior Technician | 4000 San Ernesto Blvd, Anchorage, AK 99508 | 2019-05-11 |
| Find all providers in zip 99508 | ||||
| Taxonomy Code | 322D00000X |
| Grouping | Residential Treatment Facilities |
| Classification | Residential Treatment Facility, Emotionally Disturbed Children |
| A provider facility or distinct part of the organization which renders an interdisciplinary program of mental health treatment to individuals under 21 years of age who have persistent dysfunction in major life areas. The dysfunction is of an extent and pervasiveness that requires a protected and highly structured therapeutic environment. These organizations, or distinct part of organizations, exclude those that provide acute psychiatric care, partial hospitalization, group living, therapeutic schooling, primary diagnosis substance abuse disorder treatment, or primary diagnosis mental retardation or developmental disability treatment. |
| Notes: Source: U.S. Department of Defense Regulation 6010.8-R, Chapter 6. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972637361 | Alaska Baptist Family Services | Residential Treatment Facility, Emotionally Disturbed Children | 1600 Omalley Rd, Anchorage, AK 99507-7301 | 2007-03-15 |
| 1902169253 | The Salvation Army | Residential Treatment Facility, Emotionally Disturbed Children | 3600 E 20th Ave, Anchorage, AK 99508 | 2012-06-21 |
| 1326262890 | The Salvation Army Booth Memorial Cares for Kids Nursery | Residential Treatment Facility, Emotionally Disturbed Children | 3600 E 20th Ave, Anchorage, AK 99508-3416 | 2007-04-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982228177 | Juneau Youth Services, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 8460 Rainbow Row, Juneau, AK 99801-9041 | 2020-06-03 |
| 1447874631 | Juneau Youth Services, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 10815 Black Bear Rd, Juneau, AK 99801-8783 | 2020-06-03 |
| 1043834245 | Juneau Youth Services, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 10685 Mendenhall Loop Rd, Juneau, AK 99801 | 2020-06-03 |
| 1295359511 | Juneau Youth Services, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 10801 Black Bear Rd, Juneau, AK 99801 | 2020-06-02 |
| 1700400033 | Juneau Youth Services, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 10685 Mendenhall Lp Rd, Juneau, AK 99801 | 2020-06-02 |
| 1417502998 | Christopher Robert Jackson | Residential Treatment Facility, Emotionally Disturbed Children | 1502 Liatris Ln, North Pole, AK 99705-5082 | 2019-08-01 |
| 1326396821 | Presbyterian Hospitality House | Residential Treatment Facility, Emotionally Disturbed Children | 2771 E Hiawatha Dr, Wasilla, AK 99654-2853 | 2012-08-15 |
| 1598013096 | Presbyterian Hospitality House | Residential Treatment Facility, Emotionally Disturbed Children | 1145 W Granville St, Palmer, AK 99645-7118 | 2012-08-15 |
| 1639425812 | Presbyterian Hospitality House | Residential Treatment Facility, Emotionally Disturbed Children | 6969 S Hood Ct, Wasilla, AK 99624 | 2012-07-25 |
| 1457528366 | Boys and Girls Home of Alaska | Residential Treatment Facility, Emotionally Disturbed Children | 3101 Lathrop Street, Fairbanks, AK 99707-0870 | 2008-05-09 |
| Find all providers with the same taxonomy | ||||
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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.