BANYAN ALASKA, LLC is a substance abuse rehabilitation facility in Wasilla, AK. The provider is a facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances. BANYAN ALASKA, LLC NPI is 1902518848. The provider is registered as an organization entity type.
The provider's business location address is:
4750 E BEGICH CIRCLE
WASILLA, AK
ZIP 99654
Phone: (888) 879-4975
Fax: (954) 781-7173
The provider's authorized official is Rene Molina .
The authorized official title is Director Of Credentialing & Contrac and has the following contact phone number (954) 533-7705.
The CLIA number assigned to this NPI record is 02D2276977 - other - substance abuse treatment with a certificate type of Certificate of Waiver.
The enumeration date for this NPI number is 12/22/2022 and was last updated on 12/23/2022.