Organization
BEHIND THE SUN THERAPEUTICS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL H JOHNSON LCSW (SOLE MEMBER)
(907) 422-7504
Entity
Organization
Contact information
Practice address
500 ADAMS STREET, BOX 3243, SEWARD, AK 99664-3243
(907) 422-7504
Mailing address
PO BOX 221795, ANCHORAGE, AK 99522-1795
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
1390
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1487032751
PERSONAL NPI
AK
Enumeration date
06/27/2016
Last updated
06/27/2016
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