Richard Andrew Clancy Parks | Anchorage, AK • PECOS Search

Richard Andrew Clancy Parks

Behavior Technician

Behavioral Health & Social Service Providers

4000 San Ernesto Ave, Anchorage, AK 99508-2874

(907) 739-5020 (907) 729-6351

PECOS Enrollment

Based on the most recent information from CMS, provider Richard Andrew Clancy Parks does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records yesterday at 12:57 PM.

Profile Details

Provider ID
1316684525
Provider Type
Individual
Full Name
Parks, Richard Andrew Clancy
Gender
Male

Sole Proprietor
Yes
Enumeration Date
5/18/2022
Last Updated
5/18/2022

Contact Information

Practice Location

4000 San Ernesto Ave, Anchorage, AK 99508-2874

Unlisted Fax

Mailing Location

7033 E Tudor Rd, Anchorage, AK 99507-1262

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 106S00000X Primary	Description Behavior Technician Behavioral Health & Social Service Providers	License Unlisted Issuer