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GREATLAND MENTAL HEALTH, LLC

Mental Health >> Counselor >> Behavioral Health & Social Service Providers

Registrant NPI Number: 1477743532

Organizational Registrant:
Organization Name:  GREATLAND MENTAL HEALTH, LLC
Organization is not Subpart
Authorized Official:  THERESA M RONCO  BILLING MANAGER  907--63-27577

Location and contact information for practice:
1407 W 31ST AVE STE 201 ANCHORAGE, AK 99503-3678 US
Tel: 907-929-4009  Fax: 907-929-4902

Contact information for business:
PO BOX 111810  ANCHORAGE, AK 99511-1810 US
Tel: 907-929-4009  Fax: 907-929-4902

Registration Information:
NPI: 1477743532
Entity Type: Organization

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
N101YM0800XBehavioral Health & Social Service Providers
Counselor
Mental Health
Y2084P0800XAllopathic & Osteopathic Physicians
Psychiatry & Neurology

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
MH3538AK05




HEALTH CARE JOBS AK - Page 1



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