Montie Dale Ford, CDC 1 - Fairbanks, AK

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.

Location: 1825 Marika Rd, Fairbanks, AK, 99709-5521

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

Identifier	Type	State	Issuer
DA3237	05	AK
MH3237	05	AK

Address

1825 Marika Rd

City

Fairbanks

State

Alaska

Zip

99709-5521

Phone Number

907-474-0890

Fax Number

907-474-3621

Address

1825 Marika Rd

City

Fairbanks

State

Alaska

Zip

99709-5521

Phone Number

907-474-0890

Fax Number

907-474-3621

Type

Residential Treatment Facilities

Classification

Residential Treatment Facility, Emotionally Disturbed Children

Speciality

Taxonomy

322D00000X

License No.

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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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