THE SALVATION ARMY BOOTH MEMORIAL RESIDENTIAL CHILDCARE


Address: 3600 E 20th Ave, Anchorage, AK 99508-3416
Phone: 9072790522

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).

Provider Overview

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

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 322D00000X Residential Treatment Facility, Emotionally Disturbed Children 11806 AK Residential Treatment Facilities

Other Provider Identifier

State Issuer Identifier Type Code
AK BR0005 05

Office Location

Street Address 3600 E 20TH AVE
City ANCHORAGE
State AK
Zip Code 99508-3416

Providers in the same location

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

Providers in the same zip code

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
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Taxonomy Information

Taxonomy Code 322D00000X
Grouping Residential Treatment Facilities
Classification Residential Treatment Facility, Emotionally Disturbed Children

Taxonomy Definition

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.

Providers in the same taxonomy and city

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

Providers in the same taxonomy and state

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
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Competitor

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City ANCHORAGE
Zip Code 99508

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Dataset Information

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.

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