NPIMap

Organization Active NPI

Fairbanks Native Association

Doing business as Women and Children's Center for Inner Healing

  • Substance Abuse Rehabilitation Facility
  • Fairbanks, AK
National Provider Identifier
1578736211
Registry record updated Nov 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
License
76821 Issued in AK
Legal business name
FAIRBANKS NATIVE ASSOCIATION
Doing business as
Women and Children's Center for Inner Healing
Practice address
1027 Evergreen St
Fairbanks, AK 99709-4306
Phone
(907) 451-8164
Fax
(907) 456-4849
NPI assigned
Apr 2, 2008
Last updated
Nov 8, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Perry Ahsogeak
Title
BHS Director
Phone
(907) 452-6251

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Abuse Rehabilitation Facility 324500000X 76821 AK Primary

Addresses

Primary practice location

1027 Evergreen St
Fairbanks, AK 99709-4306

Mailing address

315 Wendell Ave
Fairbanks, AK 99701-4837
Phone (907) 452-6251

Other identifiers 1

IdentifierTypeStateIssuer
1696805MedicaidAK

Other names 1

  • Women and Children's Center for Inner Healing Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Fairbanks Native Association6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1027 Evergreen St
Fairbanks, AK 99709
Phone (907) 451-8164

605 Hughes Ave
Fairbanks, AK 99701
Phone (907) 452-1648

Practitioners & affiliated clinicians

Practitioners 20

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 20

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1207094400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1573171200000",
    "number": "1578736211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "315 WENDELL AVE",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997014837",
            "telephone_number": "907-452-6251",
            "fax_number": "907-452-1001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1027 EVERGREEN ST",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997094306",
            "telephone_number": "907-451-8164",
            "fax_number": "907-456-4849"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAIRBANKS NATIVE ASSOCIATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-02",
        "last_updated": "2019-11-08",
        "status": "A",
        "authorized_official_last_name": "AHSOGEAK",
        "authorized_official_first_name": "PERRY",
        "authorized_official_title_or_position": "BHS DIRECTOR",
        "authorized_official_telephone_number": "907-452-6251"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "AK",
            "license": "76821",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1696805",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Women and Children's Center for Inner Healing",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Women and Children's Center for Inner Healing",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fairbanks, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.