Bh 1115- Pedro Bay | |
2516 Mountain Circle Pedro Bay AK 99647 | |
(907) 850-2229 | |
Not Available |
Full Name | Bh 1115- Pedro Bay |
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Speciality | Community/behavioral Health |
Location | 2516 Mountain Circle, Pedro Bay, 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 |
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Bh 1115- Pedro Bay Po Box 35198 Seattle WA 98124-5198 Ph: () - | Bh 1115- Pedro Bay 2516 Mountain Circle Pedro Bay AK 99647 Ph: (907) 850-2229 |
NPI Number | 1780287920 |
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Provider Enumeration Date | 11/19/2020 |
Last Update Date | 09/15/2023 |
Certification Date | 09/15/2023 |
Identifier | Type | State | Issuer |
---|---|---|---|
1780287920 | NPI | - | NPPES |
1716559 | Medicaid | AK |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |