Provider Demographics
NPI:1164301172
Name:ILUAQSII
Entity type:Organization
Organization Name:ILUAQSII
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REHABILITATION PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:
Authorized Official - Last Name:YOUNG
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:907-931-4309
Mailing Address - Street 1:188 W NORTHERN LIGHTS BLVD STE 1110
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99503-3985
Mailing Address - Country:US
Mailing Address - Phone:907-931-4309
Mailing Address - Fax:
Practice Address - Street 1:188 W NORTHERN LIGHTS BLVD STE 1110
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99503-3985
Practice Address - Country:US
Practice Address - Phone:907-931-4309
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-02
Last Update Date:2025-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)