| Alaska Advanced Behavioral Health | |
|
203 West E St Nome AK 99762 | |
| (231) 388-5344 | |
| Not Available |
| Full Name | Alaska Advanced Behavioral Health |
|---|---|
| Speciality | Clinic/Center |
| Location | 203 West E St, Nome, Alaska |
| Authorized Official Name and Position | Garrick Fuller (OWNER) |
| Authorized Official Contact | 2313885344 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Alaska Advanced Behavioral Health Po Box 262 Nome AK 99762-0262 Ph: (231) 388-5344 | Alaska Advanced Behavioral Health 203 West E St Nome AK 99762 Ph: (231) 388-5344 |
| NPI Number | 1043993801 |
|---|---|
| Provider Enumeration Date | 08/09/2023 |
| Last Update Date | 08/09/2023 |
| Certification Date | 08/07/2023 |
| Medicare PECOS PAC ID | 1052760709 |
|---|---|
| Medicare Enrollment ID | O20231207000568 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043993801 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Garrick Fuller |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1760871842 PECOS PAC ID: 2961851613 Enrollment ID: I20231207000671 |
Norton Sound Health Corporation Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 306 West 5th Avenue, Nome, AK 99762 Phone: 907-443-3344 Fax: 907-443-5915 | |
Norton Sound Health Corporation Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 306 W 5th Avenue, Nome, AK 99762 Phone: 907-443-3344 Fax: 907-443-5915 | |
Norton Sound Health Corp Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 306 W 5th, Nome, AK 99762 Phone: 907-443-3311 Fax: 907-443-6412 | |
Behavioral Health Services Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 306 W. 5th Ave., Nome, AK 99762 Phone: 907-443-3311 |