| Doctor Name: | MR. BENITO ARTILLERO ACHAS |
| NPI Number: | 1295167179 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | CDC1 |
| License Number: | 2266 |
| Business Practice Address: | 717 E Rezanof Dr Kodiak, AK - 996156416 |
| Business Phone Number: | 9074812400 |
| Business Fax Number: | 9074812419 |
| Mailing Address: | 201 Kashevaroff Ave Apt 206, KODIAK |
| State: | AK |
| Postal Code: | 996156385 |
| Phone Number: | 9074863172 |
| Fax Number: | |
| NPI Enumeration Date: | 08/02/2013 |
| NPI Last Update Date: | 08/02/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | 2266 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AK |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |