# EAGLE RIVER BEHAVIORAL HEALTH, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1366062903
- **Authorized official:** ZAN WHITMAN ARNP (PROVIDER)
- **Authorized official phone:** (907) 726-0378

## Contact information

- **Practice address:** 12812 OLD GLENN HWY STE C4, EAGLE RIVER, AK 99577-7002
- **Practice address phone:** (907) 726-0378
- **Practice address fax:** (907) 726-0374
- **Mailing address:** PO BOX 770870, EAGLE RIVER, AK 99577-0870
- **Mailing address phone:** (907) 290-7033
- **Mailing address fax:** (206) 726-0374

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 04/23/2020
- **Last updated:** 05/01/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 240808 | — | AK |