person
Montie Dale Ford, CDC1
Emotionally Disturbed Childrens' Residential Treatment Facility in Fairbanks, Alaska
NPI 1891079976

Montie Dale Ford is a Emotionally Disturbed Childrens' Residential Treatment Facility based in Fairbanks, AK. Montie Dale Ford practices in Fairbanks, AK and has the professional credentials of CDC1. The NPI Number for Montie Dale Ford is 1891079976 and holds a License No. (Alaska).

The current practice location address for Montie Dale Ford is 1825 Marika Rd, Fairbanks, AK and can be reached out via phone at 907-474-0890 and via fax at 907-474-3621. You can also correspond with Montie Dale Ford through the mailing address at 1825 MARIKA RD, FAIRBANKS, AK - 99709-5521 (mailing address contact number: 907-474-0890).

Location: 1825 Marika Rd, Fairbanks, AK, 99709-5521
person
Provider Profile Details
NPI Number
1891079976
Provider Name
Montie Dale Ford
Credential
CDC1
Provider Entity Type
Individual
Gender
Male
Address
1825 Marika Rd, Fairbanks, AK, 99709-5521
Phone Number
907-474-0890
Fax Number
907-474-3621
Provider Enumeration Date
10/06/2011
Last Update Date
03/09/2024
tick
Provider's Legacy Identifiers
Identifier Type State Issuer
DA3237 05 AK
MH3237 05 AK
institution
Provider Business Practice Location Address Details
Address
1825 Marika Rd
City
State
Zip
99709-5521
Phone Number
907-474-0890
Fax Number
907-474-3621
person
Provider Business Mailing Address Details
Address
1825 Marika Rd
City
State
Zip
99709-5521
Phone Number
907-474-0890
Fax Number
907-474-3621
person
Provider's Taxonomy Details 1
Type
Residential Treatment Facilities
Classification
Residential Treatment Facility, Emotionally Disturbed Children
Speciality
-
Taxonomy
License No.
()
Definition
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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