Provider Demographics
NPI:1073307328
Name:EAGLE RIVER BEHAVIORAL HEALTH
Entity type:Organization
Organization Name:EAGLE RIVER BEHAVIORAL HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CATHERINE
Authorized Official - Middle Name:
Authorized Official - Last Name:HAESE
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP
Authorized Official - Phone:907-317-5883
Mailing Address - Street 1:PO BOX 770870
Mailing Address - Street 2:
Mailing Address - City:EAGLE RIVER
Mailing Address - State:AK
Mailing Address - Zip Code:99577-0870
Mailing Address - Country:US
Mailing Address - Phone:907-726-0378
Mailing Address - Fax:907-726-0374
Practice Address - Street 1:12812 OLD GLENN HWY STE C4
Practice Address - Street 2:
Practice Address - City:EAGLE RIVER
Practice Address - State:AK
Practice Address - Zip Code:99577-7002
Practice Address - Country:US
Practice Address - Phone:907-726-0378
Practice Address - Fax:907-726-0374
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-09
Last Update Date:2025-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty