Organization · NPI-2

Advanced Telepsychiatry Of Alaska LLC

Clinic/Center, Adult Mental Health · Eagle River, AK

NPI number1609467364
StatusActive
Last updated in NPPESJan 26, 2021

Details

NPI
1609467364
Entity type
Organization (NPI-2)
Legal business name
Advanced Telepsychiatry Of Alaska LLC
Organization subpart
No
Enumeration date
Jan 26, 2021
Certification date
Jan 26, 2021
Last updated
Jan 26, 2021

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
261QM0850X Clinic/Center, Adult Mental Health––Yes
261QM0855X Clinic/Center, Adolescent and Children Mental Health––

Practice location

11470 Business Blvd
Eagle River, AK 99577-7780

Phone 907-406-6690

Mailing address

Po Box 770824
Eagle River, AK 99577-0824

Phone 907-406-6690 · Fax 907-726-0336

Other practice locations

10943 Splendor Loop
Eagle River, AK 99577-8198

Phone 907-406-6690

Authorized official

Amber Virden
Aprn
9074066690

Is something wrong?

This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.

Other Clinic/Center, Adult Mental Health providers in Eagle River, AK