Presbyterian Hospitality House
Residential Treatment Facility, Emotionally Disturbed Children in Fairbanks, AK. Organization (NPI-2).
Details
- NPI
- 1629299441
- Entity type
- Organization (NPI-2)
- Legal business name
- Presbyterian Hospitality House
- Organization subpart
- No
- Enumeration date
- May 1, 2007
- Last updated
- Nov 1, 2012
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 322D00000X | Residential Treatment Facility, Emotionally Disturbed Children | – | AK | Yes |
Other names
- Mitchell Home (Other Name)
Practice location
3809 Mitchell AveFairbanks, AK 99709-4638
Phone 907-456-6445 · Fax 907-456-6402
Mailing address
209 Forty Mile AveFairbanks, AK 99701-3110
Phone 907-456-6445
Authorized official
Drenda Tigner
Excutive Director
9074566445
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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