Organization
SILVER MOON MENTAL HEALTH THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EDI LANE GRIGGS HALSTEAD LPC (OWNER)
(855) 914-5621
Entity
Organization
Contact information
Practice address
1901 N HEMMER RD # 203, PALMER, AK 99645-9690
(855) 914-5621
Mailing address
1950 S BODENBURG LOOP, PALMER, AK 99645-7617
(855) 914-5621
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
07/15/2022
Last updated
07/15/2022
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