NPIMap

Organization Active NPI

Set Free Alaska, Inc.

  • Substance Abuse Rehabilitation Facility
  • Homer, AK
National Provider Identifier
1780220012
Registry record updated Aug 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
Legal business name
SET FREE ALASKA, INC.
Practice address
51310 Timber Bay Court
Homer, AK 99603-9968
Phone
(907) 373-4732
NPI assigned
Nov 21, 2019
Organization subpart
Yes
Parent organization
SET FREE ALASKA, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 19, 2024

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

Authorized official

Name
Joyce Stein
Title
Cfo
Phone
(907) 373-4732

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X
Substance Abuse Rehabilitation Facility 324500000X Primary

Addresses

Primary practice location

51310 Timber Bay Court
Homer, AK 99603-9968

Mailing address

PO Box 876741
Wasilla, AK 99687-6741
Phone (907) 373-4732

Other identifiers 2

IdentifierTypeStateIssuer
1706868MedicaidAK
602-239-20011OtherAKSTATE OF ALASKA GRANT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AK

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200827003677 AK Part B Supplier - Clinic/Group Practice 2668899204 Receives reassigned benefits from 2 practitioners
6 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Wasilla, AK; Palmer, AK; Homer, AK

Other NPIs on the same Medicare enrollment 6

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Set Free Alaska Inc8 organizations share this tax ID, including this one
Part of
Set Free Alaska Inc

Other organizations with this tax ID 7

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

NPI Registry JSON

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

{
    "created_epoch": "1574294400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724025600000",
    "number": "1780220012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 876741",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996876741",
            "telephone_number": "907-373-4732"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "51310 TIMBER BAY COURT",
            "city": "HOMER",
            "state": "AK",
            "postal_code": "996039968",
            "telephone_number": "907-373-4732"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SET FREE ALASKA, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SET FREE ALASKA, INC.",
        "enumeration_date": "2019-11-21",
        "last_updated": "2024-08-19",
        "certification_date": "2024-08-19",
        "status": "A",
        "authorized_official_last_name": "STEIN",
        "authorized_official_first_name": "JOYCE",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "907-373-4732"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1706868",
            "state": "AK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF ALASKA GRANT",
            "identifier": "602-239-20011",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Homer, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.