Healthcare Provider Details

I. General information

NPI: 1831472000
Provider Name (Legal Business Name): ORION BEHAVIORAL HEALTH NETWORK
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/23/2011
Last Update Date: 09/23/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2530 DEBARR RD
ANCHORAGE AK
99508-2948
US

IV. Provider business mailing address

PO BOX 200423
ANCHORAGE AK
99520-0423
US

V. Phone/Fax

Practice location:
  • Phone: 907-264-4390
  • Fax:
Mailing address:
  • Phone: 907-264-4390
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License NumberA5403
License Number StateAK
# 2
Primary TaxonomyY
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License NumberA5430
License Number StateAK

VIII. Authorized Official

Name: DR. AROM J EVANS
Title or Position: CEO
Credential: MD
Phone: 907-264-4390