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General NPI Number Information
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NPI Number | 1710712179
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Entity Type | Organization
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Legal Business Name | PSYCHIATRIC AND ADDICTION RECOVERY CENTER OF ALASKA, LLC
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Dates
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Enumeration Date | 09/05/2024
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Last Update Date | 09/05/2024
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Provider Practice Location Address
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Address Line | 750 W DIMOND BLVD STE 103
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City | ANCHORAGE
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State | AK
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Zip | 99515-1500
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Country | US
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Telephone | 314-620-7850
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Fax |
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Provider Business Mailing Address
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Address Line | 750 W DIMOND BLVD STE 103
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City | ANCHORAGE
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State | AK
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Zip | 99515-1500
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | APRN
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Name | ALEKSANDRA SWAN
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Credential | APRN
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Telephone | 314-620-7850
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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