SOUTHEAST ALASKA REGIONAL HEALTH CONSORTIUM (NPI# 1972134864) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972134864 |
| Entity Type | Organization |
| Organization Name | SOUTHEAST ALASKA REGIONAL HEALTH CONSORTIUM |
| Practice Address |
105 Totem Way Kake AK 99830 |
| Mailing Address |
3100 Channel Dr Ste 300 Juneau AK 99801-7837 |
| Practice Telephone | 9077853333 |
| Practice Fax Number | 9077853136 |
| Mailing Telephone | 9074634074 |
| Mailing Fax Number | 9074631510 |
| Enumeration Date | 2020-01-29 |
| Last Update Date | 2020-01-29 |
| Authorized Official Name | DANIEL HARRIS (VP/ CFO) |
| Authorized Official Telephone | 9074634000 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251S00000X | Community/Behavioral Health | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AK | STATE OF ALASKA | 70206 | 01 |
| Other Name | Type Code |
|---|---|
| 1115 SUD Waiver | Other Name - Individual/Organization |
| SEARHC Kake Behavioral Health | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831720713 | Southeast Alaska Regional Health Consortium | Community/Behavioral Health | 202 2nd & Gjoa Street, Petersburg, AK 99833 | 2020-01-30 |
| 1104457084 | Southeast Alaska Regional Health Consortium | Community/Behavioral Health | Eight Street Extension, Hydaburg, AK 99922 | 2020-01-30 |
| 1841843794 | Southeast Alaska Regional Health Consortium | Community/Behavioral Health | 1200 Seward Avenue, Sitka, AK 99835 | 2019-07-19 |
| 1992358840 | Southeast Alaska Regional Health Consortium | Community/Behavioral Health | 1212 Seward Avenue, Sitka, AK 99835 | 2019-07-19 |
| 1952815706 | Southeast Alaska Regional Health Consortium | Home Health | 814 Halibut Point Rd Ste 202, Sitka, AK 99835-7101 | 2017-11-30 |
| 1063958452 | Southeast Alaska Regional Health Consortium | Clinic/Center | Cannery Site, Excursion Inlet, AK 99850 | 2017-01-10 |
| 1194261594 | Southeast Alaska Regional Health Consortium | Community/Behavioral Health | 225 Front Street, Juneau, AK 99801 | 2017-01-10 |
| 1962948356 | Southeast Alaska Regional Health Consortium | Clinic/Center | Community Building, Port Protection, AK 99950 | 2017-01-10 |
| 1659817054 | Southeast Alaska Regional Health Consortium | Clinic/Center | Naukati Community Church, Naukati, AK 99950 | 2017-01-10 |
| 1932645512 | Southeast Alaska Regional Health Consortium | Clinic/Center | 105 Nw Kodiak Dr, Coffman Cove, AK 99918 | 2017-01-06 |
| Street Address |
105 TOTEM WAY |
| City | KAKE |
| State | AK |
| Zip Code | 99830 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114973849 | South East Alaska Regional Health Consortium | Clinic/Center | 105 Totem Way, Kake, AK 99830 | 2006-05-25 |
| 1558918631 | Antonio Lee Abbott | Behavior Technician | 105 Totem Way, Kake, AK 99830-0605 | 2019-08-22 |
| 1780954214 | Donna L Millan | Nurse Practitioner | 105 Totem Way, Kake, AK 99830-0605 | 2011-12-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497125637 | Anthony Gastelum | Counselor | 101 Totem St., Kake Clinic, Kake, AK 99830 | 2015-09-30 |
| 1730446188 | Kimberly Ann Moler | Community Health Worker | 101 Totem Way, Kake, AK 99830 | 2012-04-23 |
| 1265658231 | City of Kake | Ambulance | 26 Church Street, Kake, AK 99830 | 2007-04-18 |
| 1225156136 | Catholic Community Service | Case Management | 177 3rd Ave, Kake, AK 99830-0251 | 2007-03-27 |
| Taxonomy Code | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700483781 | Anchorage Community Mental Health Services, Inc | Community/Behavioral Health | 704 W 26th Ave, Anchorage, AK 99503-2532 | 2020-10-03 |
| 1992314215 | Residential Youth Care, Inc. | Community/Behavioral Health | 2442 Tongass Avenue, Ketchikan, AK 99901 | 2020-07-23 |
| 1124646641 | Alaska Art Therapy and Counseling | Community/Behavioral Health | 1107 W 8th St Unit 5, Juneau, AK 99801-1853 | 2020-07-10 |
| 1316563026 | Residential Youth Care, Inc. | Community/Behavioral Health | 606 Hill Road, Ketchikan, AK 99901 | 2020-06-18 |
| 1043836851 | Residential Youth Care, Inc. | Community/Behavioral Health | 2514 1st Avenue, Ketchikan, AK 99901 | 2020-06-18 |
| 1215553029 | Residential Youth Care, Inc. | Community/Behavioral Health | 2951 Baranof Avenue, Ketchikan, AK 99901 | 2020-06-18 |
| 1316561509 | Juneau Youth Services, Inc. | Community/Behavioral Health | 1507 3rd St, Douglas, AK 99824 | 2020-06-03 |
| 1225652407 | Juneau Youth Services, Inc. | Community/Behavioral Health | 1600 Renninger St, Juneau, AK 99801 | 2020-06-03 |
| 1316561590 | Juneau Youth Services, Inc. | Community/Behavioral Health | 2901 Riverside Dr, Juneau, AK 99801 | 2020-06-03 |
| 1366066540 | Juneau Youth Services, Inc. | Community/Behavioral Health | 3400 Tongass Blvd, Juneau, AK 99801 | 2020-06-03 |
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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.