Provider Demographics
NPI:1841970209
Name:BEHIND THE SUN THERAPEUTICS, LLC
Entity type:Organization
Organization Name:BEHIND THE SUN THERAPEUTICS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:H
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW, PHD
Authorized Official - Phone:907-422-7504
Mailing Address - Street 1:PO BOX 221795
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99522-1795
Mailing Address - Country:US
Mailing Address - Phone:907-231-4893
Mailing Address - Fax:844-880-8349
Practice Address - Street 1:500 ADAMS ST STE 202
Practice Address - Street 2:
Practice Address - City:SEWARD
Practice Address - State:AK
Practice Address - Zip Code:99664-0640
Practice Address - Country:US
Practice Address - Phone:907-422-7504
Practice Address - Fax:907-290-2559
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-20
Last Update Date:2023-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral HealthGroup - Multi-Specialty