Organization
SEARHC MONTANA CREEK RESIDENTIAL FACILITY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID EDWARDS (VP OF FINANCE)
(907) 463-4061
Entity
Organization
Contact information
Practice address
10801 BLACK BEAR ROAD, JUNEAU, AK 99801-7809
(907) 523-6582
(907) 789-1265
Mailing address
222 TONGASS DR, SITKA, AK 99835-9416
(907) 966-2411
(907) 966-8606
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
70206
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
MH6274
—
AK
Enumeration date
03/21/2007
Last updated
08/22/2020
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