Healthcare Provider Details

I. General information

NPI: 1841110640
Provider Name (Legal Business Name): AIDAN DURAN BHA II
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/20/2026
Last Update Date: 07/20/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26341 EKLUTNA VILLAGE RD
CHUGIAK AK
99567-5148
US

IV. Provider business mailing address

26339 EKLUTNA VILLAGE RD
CHUGIAK AK
99567-5148
US

V. Phone/Fax

Practice location:
  • Phone: 907-691-6020
  • Fax:
Mailing address:
  • Phone: 907-688-6020
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number2600915BHAII
License Number StateAK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: