Tribal/hpg- Icm (intensive Case Management) | |
400 W Benson Blvd Anchorage AK 99503-3829 | |
(907) 729-2500 | |
Not Available |
Full Name | Tribal/hpg- Icm (intensive Case Management) |
---|---|
Speciality | Clinic/center - Multi-specialty |
Location | 400 W Benson Blvd, Anchorage, Alaska |
Authorized Official Name and Position | Ronald Lee Olson (EXECUTIVE VICE PRESIDENT FINANCE) |
Authorized Official Contact | 9077294939 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Tribal/hpg- Icm (intensive Case Management) Po Box 35198 Seattle WA 98124-5198 Ph: () - | Tribal/hpg- Icm (intensive Case Management) 400 W Benson Blvd Anchorage AK 99503-3829 Ph: (907) 729-2500 |
NPI Number | 1780277830 |
---|---|
Provider Enumeration Date | 02/18/2021 |
Last Update Date | 09/14/2023 |
Identifier | Type | State | Issuer |
---|---|---|---|
1780277830 | NPI | - | NPPES |
1730741 | Medicaid | AK | |
1733640 | Medicaid | AK |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
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