Organization
FOOTHILLS BEHAVIORAL HEALTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JASON MARTIN PMHNP (OWNER)
(208) 360-0288
Entity
Organization
Contact information
Practice address
16635 CENTERFIELD DR STE 204, EAGLE RIVER, AK 99577-7746
(907) 694-2300
(907) 694-2330
Mailing address
16635 CENTERFIELD DR STE 204, EAGLE RIVER, AK 99577-7746
(907) 694-2300
(907) 694-2330
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
11/09/2021
Last updated
11/29/2021
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