| Indian Creek Bsd Clinic | |
|
101 Indian Creek Road Tyonek AK 99682 | |
| (907) 583-2461 | |
| Not Available |
| Full Name | Indian Creek Bsd Clinic |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 101 Indian Creek Road, Tyonek, Alaska |
| Authorized Official Name and Position | Ronald Lee Olson (VP FINANCE) |
| Authorized Official Contact | 9077294939 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Indian Creek Bsd Clinic 4501 Diplomacy Dr Anchorage AK 99508-5919 Ph: (907) 729-4955 | Indian Creek Bsd Clinic 101 Indian Creek Road Tyonek AK 99682 Ph: (907) 583-2461 |
| NPI Number | 1548628555 |
|---|---|
| Provider Enumeration Date | 02/04/2016 |
| Last Update Date | 03/15/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548628555 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | 20467 (Alaska) | Primary |