Ill Learning Lab

LBN: Presbyterian Hospitality House
Ill Learning Lab is an health care organization with primary practice located at 209 Forty Mile Ave Suite #100, Fairbanks AK 99701. The organization recently has only one registered license in Residential Treatment Facilities / Residential Treatment Facility, Emotionally Disturbed Children, which is considered as the primary health care specialty. Presbyterian Hospitality House can be contacted via phone (907) 456-6445, or through Tigner, Drenda via phone (907) 456-6445.

Contact Information

Primary practice address
209 Forty Mile Ave Suite #100 Fairbanks AK 99701
Phone: (907) 456-6445
Fax: (907) 456-6402
Website:
Map and Directions
Authorized official contact:
Name: Tigner, Drenda Master of Arts (MA)
Phone: (907) 456-6445

Health care specialties

SpecialtyCodeLicense #State
Residential Treatment Facilities / Residential Treatment Facility, Emotionally Disturbed Children 322D00000X Alaska

Profile Details

NPI number 1609097476
LBN Legal business name Presbyterian Hospitality House
DBA Doing business as Ill Learning Lab
Authorized official Tigner, Drenda Master of Arts (MA)
Entity Organization
Organization subpart 1 No
Enumeration date May 1st, 2007
Last updated Jul 21st, 2022 - about 2 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1609097476 NPPES
Alaska MEDICAID MH2770

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