| Bh 1115- Kkgb Cfds | |
|
4441 Diplomacy Dr Anchorage AK 99508-5910 | |
| (907) 729-8880 | |
| Not Available |
| Full Name | Bh 1115- Kkgb Cfds |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 4441 Diplomacy Dr, Anchorage, Alaska |
| Authorized Official Name and Position | Ronald Lee Olson (EXECUTIVE VICE PRESIDENT FINANCE) |
| Authorized Official Contact | 9077294939 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bh 1115- Kkgb Cfds 7033 E Tudor Rd Anchorage AK 99507-1262 Ph: () - | Bh 1115- Kkgb Cfds 4441 Diplomacy Dr Anchorage AK 99508-5910 Ph: (907) 729-8880 |
| NPI Number | 1659924108 |
|---|---|
| Provider Enumeration Date | 07/23/2019 |
| Last Update Date | 08/28/2024 |
| Certification Date | 08/28/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659924108 | NPI | - | NPPES |
| 1696891 | Medicaid | AK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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