Provider Demographics
NPI:1124603188
Name:ALBA BEHAVIORAL HEALTH
Entity Type:Organization
Organization Name:ALBA BEHAVIORAL HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MARIE SHELA
Authorized Official - Middle Name:L
Authorized Official - Last Name:SALONGA
Authorized Official - Suffix:
Authorized Official - Credentials:BA, BCABA, LABA
Authorized Official - Phone:907-232-5282
Mailing Address - Street 1:17301 BEAUJOLAIS CIR
Mailing Address - Street 2:
Mailing Address - City:EAGLE RIVER
Mailing Address - State:AK
Mailing Address - Zip Code:99577-7513
Mailing Address - Country:US
Mailing Address - Phone:907-232-5282
Mailing Address - Fax:
Practice Address - Street 1:17301 BEAUJOLAIS CIR
Practice Address - Street 2:
Practice Address - City:EAGLE RIVER
Practice Address - State:AK
Practice Address - Zip Code:99577-7513
Practice Address - Country:US
Practice Address - Phone:907-232-5282
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-11
Last Update Date:2021-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty