Organization Name: | SOUTH PENINSULA BEHAVIORAL HEALTH SVCS INC |
NPI Number: | 1124244660 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | NINA ALLEN (CHIEF EXECUTIVE OFFICER) |
Mailing Address: | 3948 Ben Walters Ln Homer |
State: | AK US |
Postal Code: | 996037708 |
Phone Number: | 9072357701 |
Fax Number: | 9072359147 |
NPI Enumeration Date: | 04/17/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 385H00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Respite Care Facility |
Taxonomy Classification: | Respite Care |
Taxonomy Specialization: | |
Taxonomy Definition: |