| Community Mental Health Center | |
|
3948 Ben Walters Ln Homer AK 99603-7708 | |
| (907) 235-7701 | |
| Not Available |
| Full Name | Community Mental Health Center |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 3948 Ben Walters Ln, Homer, Alaska |
| Authorized Official Name and Position | Jay Bechtol (CEO) |
| Authorized Official Contact | 9072359229 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Community Mental Health Center 3948 Ben Walters Ln Homer AK 99603-7708 Ph: (907) 235-7701 | Community Mental Health Center 3948 Ben Walters Ln Homer AK 99603-7708 Ph: (907) 235-7701 |
| NPI Number | 1285640961 |
|---|---|
| Provider Enumeration Date | 08/01/2006 |
| Last Update Date | 05/09/2017 |
| Medicare PECOS PAC ID | 3971495136 |
|---|---|
| Medicare Enrollment ID | O20040325000342 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285640961 | NPI | - | NPPES |
| 1020987 | Medicaid | AK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Christopher C Wall |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588847917 PECOS PAC ID: 0244497873 Enrollment ID: I20190111001407 |
| Provider Name | Savannah Mallory Wilhite |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992128383 PECOS PAC ID: 6608191721 Enrollment ID: I20190523002003 |
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