NPI 1295389120

Jared Michael Anderson

Practitioner Emotionally Disturbed Childrens' Residential Treatment Facility Fairbanks, AK

Practice location

Address: 3101 Lathrop St, Fairbanks, AK 99701-7426
Phone: (907) 459-4700
Mailing address: 2252 Arlene Dr, Fairbanks, AK 99705-7560

Registered specialties

Emotionally Disturbed Childrens' Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 322D00000X

Other Residential Treatment Facility, Emotionally Disturbed Children providers in Alaska →

Registry record

NPI: 1295389120
Entity type: Individual
Sex (as registered): Male
NPI issued: 29 Jul 2019
Record last updated: 29 Jul 2019

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.