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MONTIE DALE FORD CDC 1
NPI 1891079976
Residential Treatment Facility, Emotionally Disturbed Children in Fairbanks, AK

Active since October 06, 2011
1825 MARIKA RD, FAIRBANKS, AK 99709(907) 474-0890(907) 474-3621 Get Directions Write a Review

NPPES record last updated: October 6, 2011. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Montie Dale Ford Cdc 1 NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MONTIE DALE FORD CDC 1 (NPI 1891079976) is an individual residential treatment facility, emotionally disturbed children provider in Fairbanks, Alaska and active in the NPI registry since October 2011.

NPPES Registry Identity

NPI1891079976
Entity TypeIndividualMale
Primary Taxonomy322D00000X
Provider Legal NameMONTIE DALE FORDCredential: CDC 1
Location Address1825 MARIKA RDFairbanks, AK 99709-5521
Mailing Address1825 Marika RdFairbanks, AK 99709-5521 · (907) 474-0890 · Fax (907) 474-3621
Phone(907) 474-0890
Fax(907) 474-3621
Sole ProprietorYes
Enumeration DateOctober 6, 2011
✔ NPI 1891079976 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyResidential Treatment Facility, Emotionally Disturbed ChildrenResidential Treatment Facilities
Taxonomy Code322D00000X
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.
1825 MARIKA RD, Fairbanks, AK 99709
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Other Identifiers 2

MedicaidDA3237AK
MedicaidMH3237AK

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JOHN DUNCAN
Counselor
1825 MARIKA RD
FAIRBANKS, AK 99709
Fairbanks North Star Borough (907) 474-0890
RACHAEL ELIZABETH TAYLOR
Community Health Worker
1825 MARIKA RD
FAIRBANKS, AK 99709
Fairbanks North Star Borough (907) 474-0890
MR. VERNON GENE ROHRER
Counselor
1825 MARIKA RD
FAIRBANKS, AK 99709
Fairbanks North Star Borough (907) 474-0890
RACHEL HOUSER
Community Health Worker
1825 MARIKA RD
FAIRBANKS, AK 99709
Fairbanks North Star Borough (907) 474-0890
AMBER LOVEN-GREE
Counselor
1825 MARIKA RD
FAIRBANKS, AK 99709
Fairbanks North Star Borough (907) 474-0890
KYLE BOCK
Counselor
1825 MARIKA RD
FAIRBANKS, AK 99709
Fairbanks North Star Borough (907) 474-0890
NATALIE CALHOUN
Community Health Worker
1825 MARIKA RD
FAIRBANKS, AK 99709
Fairbanks North Star Borough (907) 474-0890
MRS. CANDACE ALEXIS BLACKWOOD MS
Counselor (Mental Health)
1825 MARIKA RD
FAIRBANKS, AK 99709
Fairbanks North Star Borough (907) 474-0890

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Montie Ford's NPI number?

The NPI number for Montie Ford is 1891079976. It was assigned to this individual provider in the NPPES registry on October 6, 2011.

Where is Montie Ford located?

Montie Ford practices at 1825 Marika Rd, Fairbanks, AK 99709. The listed phone number is (907) 474-0890.

What is Montie Ford's specialty?

The primary specialty registered for this NPI is Residential Treatment Facility, Emotionally Disturbed Children with taxonomy code 322D00000X.

When was this NPI record last updated?

The NPPES record for Montie Ford was last updated on October 6, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.