Individual provider · Type 1 NPI

Montie Dale Ford, CDC 1

Emotionally Disturbed Childrens' Residential Treatment Facility · Fairbanks, AK

NPI number 1891079976 Active

Practice location

1825 Marika Rd
Fairbanks, AK 99709-5521

Call (907) 474-0890 Map

Fax (907) 474-3621

Specialties and licenses

TaxonomyCodeLicense
Emotionally Disturbed Childrens' Residential Treatment Facility Primary 322D00000XNone listed

Emotionally Disturbed Childrens' Residential Treatment Facility: A residential facility that provides habilitation services and other care and treatment to children diagnosed with mental health illness, behavioral issues, and intellectual disabilities and are not able to live independently.

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About NPI 1891079976

Montie Dale Ford, CDC 1's National Provider Identifier is 1891079976, issued on Oct 6, 2011. The primary taxonomy on file is Emotionally Disturbed Childrens' Residential Treatment Facility (322D00000X), and the practice location is in Fairbanks, AK. The record was last updated on Oct 6, 2011.