BEHAVIORAL HEALTH UNDER 1115 WAIVER
NPI 1124110796
Community/Behavioral Health in Soldotna, AK
NPI Status: Active since September 29, 2006
Contact Information
230 E MARYDALE AVE
SOLDOTNA, AK
ZIP 99669
Phone: (907) 262-3119
Fax: (907) 262-9290
- Organization
- Community/Behavioral Health
- Accepts Insurance
- CLIA Number: 02D0951956
- CLIA Cert. Type: Federally Qualified Health Center
- CLIA Exp. Date: 04-04-2028
About BEHAVIORAL HEALTH UNDER 1115 WAIVER
This page provides the complete NPI Profile along with additional information for Behavioral Health Under 1115 Waiver, a provider established in Soldotna, Alaska operating as a Community/behavioral Health. The healthcare provider is registered in the NPI registry with number 1124110796 assigned on September 2006. The practitioner's primary taxonomy code is 251S00000X. The provider is registered as an organization and their NPI record was last updated 3 years ago. The provider's other name is Behavioral Health Under 1115 Waiver. The authorized official of this NPI record is Benjamin J Wright (Ceo)
- NPI
- 1124110796
- Provider Legal Name
- PENINSULA COMMUNITY HEALTH SERVICES OF ALASKA, INC.
- Other Organization Name
- BEHAVIORAL HEALTH UNDER 1115 WAIVER
- Other Name Type
- Other Name (5)
- Entity Type
- Organization
- Location Address
- 230 E MARYDALE AVE SOLDOTNA, AK 99669
- Location Phone
- (907) 262-3119
- Location Fax
- (907) 262-9290
- Mailing Address
- PO BOX 2949 SOLDOTNA, AK 99669
- Mailing Phone
- (907) 260-7303
- Mailing Fax
- (907) 262-9290
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 09-29-2006
- Last Update Date
- 04-25-2023
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Community/Behavioral Health
- Taxonomy Code
- 251S00000X
- Type
- Agencies
- Taxonomy Description
- A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Moda Select Alaska Bronze 6500 - PPO
- Moda Select Alaska Bronze HDHP 5500 - PPO
- Moda Select Alaska Gold 1500 - PPO
- Moda Select Alaska Silver 4500 - PPO
- Moda Select Alaska Standard Bronze - PPO
- Moda Select Alaska Standard Gold - PPO
- Moda Select Alaska Standard Silver - PPO
- Moda Select Texas Bronze 8700 ($0 Virtual Urgent Care through CirrusMD) - EPO
- Moda Select Texas Bronze HDHP 7500 - EPO
- Moda Select Texas Standard Bronze - EPO
- Moda Select Texas Standard Gold - EPO
- Moda Select Texas Standard Silver - EPO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 02D0951956
- Facility Type
- Federally Qualified Health Center
- Certificate Effective Date
- April 05, 2026
- Certificate Expiration Date
- April 04, 2028
- Laboratory Director
- DR. STUART MARCOTTE
- Certificate Type
- Certificate for Provider-Performed Microscopy Procedures (PPMP)
- Certificate Type Description
- This CLIA certificate is issued to Behavioral Health Under 1115 Waiver in which a physician, midlevel practitioner or dentist that performs specific microscopy procedures during the course of a patient's visit. A limited list of provider-performed microscopy procedures is included under this certificate type, which are categorized as moderate complexity testing.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1124110796, we treat the final digit (6) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 54. The final step is to find the difference between that total and the next multiple of ten (60 - 54 = 6).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 54 is 60. The difference is the calculated check digit.
Other Providers at the Same Location
The following 20 providers are registered at the same or a nearby location.
SOLDOTNA, AK 99669
SOLDOTNA, AK 99669
SOLDOTNA, AK 99669
SOLDOTNA, AK 99669
SOLDOTNA, AK 99669
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1124110796, enumerated as an "organization" on September 29, 2006.
The provider is located at 230 E MARYDALE AVE SOLDOTNA, AK 99669 and the phone number is (907) 262-3119.
Community/Behavioral Health with taxonomy code 251S00000X.
The provider might be accepting Accepts: Moda Health Plan, Inc.. Please consult your insurance carrier or call the provider to verify.
