BANYAN ALASKA, LLC; NPI #1902518848

Contact Information

BANYAN ALASKA, LLC

4750 E BEGICH CIRCLE
WASILLA, AK 99654

Phone: 907-290-5450
Fax: 907-290-5460
Website:

Specialty	Taxonomy Code	Specialty Code	Provider Type
Substance Abuse Disorder Rehabilitation Facility	324500000X
Mental Health (Including Community Mental Health Center)	261QM0801X	B4[14]	Community Mental Health Center
Rehabilitation, Substance Use Disorder	261QR0405X

Indicates primary specialty

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NPI Profile & details for BANYAN ALASKA, LLC

NPI #	`1902518848`
LBN Legal business name	BANYAN ALASKA, LLC
Authorized official	JOHN SORY - (CEO)
Entity	Organization
Organization subpart ¹	No
Enumeration date	12/22/2022
Last updated	01/29/2026 - About 4 months ago
Identifiers	n/a

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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