Provider Demographics
NPI:1811797103
Name:BEYONDSTABLE PSYCHIATRY (POWERED BY POSITIVE DISINTEGRATION) LLC
Entity type:Organization
Organization Name:BEYONDSTABLE PSYCHIATRY (POWERED BY POSITIVE DISINTEGRATION) LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:JANUARY
Authorized Official - Last Name:JARCZEWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:907-802-7040
Mailing Address - Street 1:645 G ST STE 100
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99501-3471
Mailing Address - Country:US
Mailing Address - Phone:907-802-7040
Mailing Address - Fax:
Practice Address - Street 1:3005 W 33RD AVE APT 4
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99517-2210
Practice Address - Country:US
Practice Address - Phone:907-802-7040
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-15
Last Update Date:2025-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty