FOOTHILLS BEHAVIORAL HEALTH NPI 1992461420

NPI Information

NPI: 1992461420
Provider Name: FOOTHILLS BEHAVIORAL HEALTH
Classification: Nurse Practitioner - 363LP0808X
Entity Type: Organization

Specialization: Psychiatric/Mental Health

CLIA Number: 02D2290822

Address:
16635 CENTERFIELD DR STE 204
EAGLE RIVER, AK
ZIP 99577
Phone: (907) 694-2300
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FOOTHILLS BEHAVIORAL HEALTH is a psychiatric/mental health nurse practitioner in Eagle River, AK. FOOTHILLS BEHAVIORAL HEALTH NPI is 1992461420. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

16635 CENTERFIELD DR STE 204
EAGLE RIVER, AK
ZIP 99577-746
Phone: (907) 694-2300
Fax: (907) 694-2330

The provider's authorized official is Jason Martin .
The authorized official title is Owner and has the following contact phone number (208) 360-0288.

The CLIA number assigned to this NPI record is 02D2290822 - other - pmhnp-bc with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/9/2021 and was last updated on 11/29/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LP0808X	Nurse Practitioner	Psychiatric/Mental Health			Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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