Mat - Su Health Services Inc.

NPI #1184725210 in Wasilla, Alaska

Provider Information

NPI Number: 1184725210
Entity Type: Organization
Organization Name: Mat - Su Health Services Inc.
Primary Specialty: Clinic/Center - Mental Health (Including Community Mental Health Center)
Enumeration Date: Sep 25, 2006
Last Updated: Jun 10, 2010

Practice Location

Address: 1363 W SPRUCE AVE
City: Wasilla
State: Alaska
ZIP Code: 99654-5327
Phone: (907) 376-2411

Authorized Official

Name: MR. KEVIN MUNSON
Title: CEO
Phone: (907) 376-2411

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center - Federally Qualified Health Center (FQHC) — Federally Qualified Health Center (FQHC)	261QF0400X
Clinic/Center - Mental Health (Including Community Mental Health Center) — Mental Health (Including Community Mental Health Center)	261QM0801X	Primary

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