| Boretide Behavioral Health, Llc | |
|
3300 Arctic Blvd Ste 201 Anchorage AK 99503-4579 | |
| (907) 931-8618 | |
| Not Available |
| Full Name | Boretide Behavioral Health, Llc |
|---|---|
| Speciality | Clinic/center - Adult Mental Health |
| Location | 3300 Arctic Blvd Ste 201, Anchorage, Alaska |
| Authorized Official Name and Position | Kelly Moore (OWNER AND EMPLOYED PROVIDER) |
| Authorized Official Contact | 9079318618 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Boretide Behavioral Health, Llc 3300 Arctic Blvd Suite 201 Pmb 1279 Anchorage AK 99503-4733 Ph: (907) 931-8618 | Boretide Behavioral Health, Llc 3300 Arctic Blvd Ste 201 Anchorage AK 99503-4579 Ph: (907) 931-8618 |
| NPI Number | 1225747215 |
|---|---|
| Provider Enumeration Date | 11/17/2022 |
| Last Update Date | 02/02/2023 |
| Certification Date | 02/02/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225747215 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
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