1073307328 NPI number — EAGLE RIVER BEHAVIORAL HEALTH

Table of content: MIESCA ALEXIA MCFARLAND DO (NPI 1902435860)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1073307328 NPI number — EAGLE RIVER BEHAVIORAL HEALTH

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
EAGLE RIVER BEHAVIORAL HEALTH
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1073307328
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/09/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 770870
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
EAGLE RIVER
Provider Business Mailing Address State Name:
AK
Provider Business Mailing Address Postal Code:
99577-0870
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
907-726-0378
Provider Business Mailing Address Fax Number:
907-726-0374

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
12812 OLD GLENN HWY STE C4
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
EAGLE RIVER
Provider Business Practice Location Address State Name:
AK
Provider Business Practice Location Address Postal Code:
99577-7002
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
907-726-0378
Provider Business Practice Location Address Fax Number:
907-726-0374
Provider Enumeration Date:
04/09/2025

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
HAESE
Authorized Official First Name:
CATHERINE
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
907-317-5883

Provider Taxonomy Codes

  • Taxonomy code: 2084P0800X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)