Provider Demographics
NPI:1003464512
Name:ALASKAN SUNRISE BEHAVIORAL HEALTH, L.L.C.
Entity Type:Organization
Organization Name:ALASKAN SUNRISE BEHAVIORAL HEALTH, L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PMHNP-BC
Authorized Official - Prefix:MRS
Authorized Official - First Name:DEANNA
Authorized Official - Middle Name:MAE
Authorized Official - Last Name:CASIANO
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP-BC
Authorized Official - Phone:907-707-1201
Mailing Address - Street 1:PO BOX 1073
Mailing Address - Street 2:
Mailing Address - City:PALMER
Mailing Address - State:AK
Mailing Address - Zip Code:99645-1073
Mailing Address - Country:US
Mailing Address - Phone:907-707-1201
Mailing Address - Fax:907-707-1202
Practice Address - Street 1:634 S BAILEY ST STE 100
Practice Address - Street 2:
Practice Address - City:PALMER
Practice Address - State:AK
Practice Address - Zip Code:99645-6360
Practice Address - Country:US
Practice Address - Phone:907-707-1201
Practice Address - Fax:907-707-1202
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-28
Last Update Date:2020-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty