| Bh 1115- Port Alsworth | |
|
1 Flight Line Rd Port Alsworth AK 99653-9801 | |
| (907) 781-2256 | |
| Not Available |
| Full Name | Bh 1115- Port Alsworth |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1 Flight Line Rd, Port Alsworth, 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- Port Alsworth Po Box 35198 Seattle WA 98124-5198 Ph: () - | Bh 1115- Port Alsworth 1 Flight Line Rd Port Alsworth AK 99653-9801 Ph: (907) 781-2256 |
| NPI Number | 1902409337 |
|---|---|
| Provider Enumeration Date | 11/18/2020 |
| Last Update Date | 09/18/2023 |
| Certification Date | 09/18/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902409337 | NPI | - | NPPES |
| 1716567 | Medicaid | AK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
Port Alsworth Bsd Clinic Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1 Flight Line Road, Port Alsworth, AK 99653 Phone: 907-729-4955 |