Provider Demographics
NPI:1053960773
Name:GASTINEAU HUMAN SERVICES
Entity type:Organization
Organization Name:GASTINEAU HUMAN SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATIVE SERVICES DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:D
Authorized Official - Last Name:AEMMER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:907-780-3016
Mailing Address - Street 1:5597 AISEK STREET
Mailing Address - Street 2:
Mailing Address - City:JUNEAU
Mailing Address - State:AK
Mailing Address - Zip Code:99801-9522
Mailing Address - Country:US
Mailing Address - Phone:907-780-4338
Mailing Address - Fax:307-780-4098
Practice Address - Street 1:5597 AISEK STREET
Practice Address - Street 2:
Practice Address - City:JUNEAU
Practice Address - State:AK
Practice Address - Zip Code:99801-9522
Practice Address - Country:US
Practice Address - Phone:907-780-4338
Practice Address - Fax:307-780-4098
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-05
Last Update Date:2019-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty