FAIRBANKS NATIVE ASSOCIATION (NPI# 1184835449) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184835449 |
| Entity Type | Organization |
| Organization Name | FAIRBANKS NATIVE ASSOCIATION |
| Other Organization Name | NEW LIFE OUTPATIENT SERVICES |
| Practice Address |
3100 S Cushman St Fairbanks AK 99701-7516 |
| Practice Telephone | 9074521274 |
| Practice Fax Number | 9074521282 |
| Mailing Telephone | 9074521274 |
| Mailing Fax Number | 9074521282 |
| Enumeration Date | 2007-05-25 |
| Last Update Date | 2007-09-04 |
| Authorized Official Name | MS. BARBARA FRERICHS (LEAD COUNSELOR) |
| Authorized Official Telephone | 9074521274 |
| Authorized Official Credential | CDC1 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 251S00000X | Community/Behavioral Health | 251S00000X | AK | Agencies |
| Y | 324500000X | Substance Abuse Rehabilitation Facility | 2860 | AK | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AK | CDC1 | 2860 | 01 |
| Other Name | Type Code |
|---|---|
| New Life Outpatient Services | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508401381 | Fairbanks Native Association | Substance Abuse Rehabilitation Facility | 3100 S Cushman St, Fairbanks, AK 99701-7516 | 2019-11-15 |
| 1134764913 | Fairbanks Native Association | Substance Abuse Rehabilitation Facility | 650 Younker Ct, Fairbanks, AK 99701-7586 | 2019-11-15 |
| 1386817237 | Fairbanks Native Association | Substance Abuse Rehabilitation Facility | 2550 Lawlor Rd, Fairbanks, AK 99709-6458 | 2008-04-10 |
| 1154594216 | Fairbanks Native Association | Substance Abuse Rehabilitation Facility | 3100 S Cushman St, Fairbanks, AK 99701-7516 | 2008-04-10 |
| 1578736211 | Fairbanks Native Association | Substance Abuse Rehabilitation Facility | 1027 Evergreen St, Fairbanks, AK 99709-4306 | 2008-04-02 |
| 1982876629 | Fairbanks Native Association | Substance Abuse Rehabilitation Facility | 2550 Lawlor Rd, Fairbanks, AK 99709-6458 | 2008-04-01 |
| Street Address |
3100 S CUSHMAN ST |
| City | FAIRBANKS |
| State | AK |
| Zip Code | 99701-7516 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083618334 | Alyce Lynne Weckwerth | Nurse Practitioner | 3100 S Cushman St, Fairbanks, AK 99701-7516 | 2005-06-01 |
| 1114530003 | Judith Florence Evans | Counselor | 3100 S Cushman St, Fairbanks, AK 99701-7516 | 2020-08-28 |
| 1659984995 | Regina Lynn Davis | Counselor | 3100 S Cushman St, Fairbanks, AK 99701-7516 | 2020-08-26 |
| 1073124939 | Alyssa Ball | Social Worker | 3100 S Cushman St, Fairbanks, AK 99701-7516 | 2020-08-13 |
| 1437772266 | Stanley Anthony Kurpakus | Counselor | 3100 S Cushman St, Fairbanks, AK 99701-7516 | 2020-05-27 |
| 1023631983 | Timothy Ledna | Counselor | 3100 S Cushman St, Fairbanks, AK 99701-7516 | 2020-05-26 |
| 1508401381 | Fairbanks Native Association | Substance Abuse Rehabilitation Facility | 3100 S Cushman St, Fairbanks, AK 99701-7516 | 2019-11-15 |
| 1780235978 | Steven Wachter | Social Worker | 3100 S Cushman St, Fairbanks, AK 99701-7516 | 2019-09-27 |
| 1437703840 | Rebecca Lin Buckles | Counselor | 3100 S Cushman St, Fairbanks, AK 99701-7516 | 2019-07-25 |
| 1518510056 | Teresa L Faucette | Social Worker | 3100 S Cushman St, Fairbanks, AK 99701-7516 | 2019-07-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659984987 | Resource Center for Parents & Children, Inc. | Social Worker | 726 26th Ave, Suite #2, Fairbanks, AK 99701 | 2020-08-26 |
| 1134738982 | Aaron Paul Sarauer | Behavior Technician | 3121 Lathrop St., Fairbanks, AK 99701 | 2020-07-28 |
| 1437715505 | Fabienne Rose Marie Siddall | Case Manager/Care Coordinator | 122 1st Avenue, Fairbanks, AK 99701 | 2019-05-14 |
| 1902461957 | Jacqueline Marie Rahm | Counselor | Family Centered Services of Alaska - Rtc, 3101 Lathrop St., Fairbanks, AK 99701 | 2019-05-06 |
| 1821588989 | Corrie Wilson | Nurse Practitioner | 1025 Barnette Street, Fairbanks, AK 99701 | 2018-05-15 |
| 1922519305 | Sarishma Sangeeta Lal | Registered Nurse | 815 2nd Ave Ste 122, Fairbanks, AK 99701 | 2017-10-12 |
| 1245690569 | Christine L Simko | Naturopath | 1275 Sadler Way, Ste 100 Rm 147, Fairbanks, AK 99701 | 2016-02-29 |
| 1932581600 | Jennifer Davis | Registered Nurse | 1025 West Barnette St., Fairbanks, AK 99701 | 2015-06-18 |
| 1700272705 | John D. Zipperer Jr Md, LLC | Clinic/Center | 751 Old Richardson Hwy., Fairbanks, AK 99701 | 2015-04-07 |
| 1578957460 | Mara Justine Becker | Physician Assistant | 1717 W. Cowles St, Fairbanks, AK- ALASKA 99701 | 2015-03-27 |
| Find all providers in zip 99701 | ||||
| Taxonomy Code | 324500000X |
| Grouping | Residential Treatment Facilities |
| Classification | Substance Abuse Rehabilitation Facility |
| A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances. |
| Notes: [7/1/2003: modified title, modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508393869 | Ground Zero Wellness Center | Substance Abuse Rehabilitation Facility | 4670 Killen Ln, Fairbanks, AK 99709-3325 | 2017-05-17 |
| 1508401381 | Fairbanks Native Association | Substance Abuse Rehabilitation Facility | 3100 S Cushman St, Fairbanks, AK 99701-7516 | 2019-11-15 |
| 1134764913 | Fairbanks Native Association | Substance Abuse Rehabilitation Facility | 650 Younker Ct, Fairbanks, AK 99701-7586 | 2019-11-15 |
| 1790236578 | North Country Medical, LLC | Substance Abuse Rehabilitation Facility | 626 2nd St, Suite 201b, Fairbanks, AK 99701-3466 | 2016-10-17 |
| 1275897548 | Steven Ketzler | Substance Abuse Rehabilitation Facility | 122 1st Ave, Suite 600, Fairbanks, AK 99701-4803 | 2012-07-01 |
| 1013205608 | Tanana Chiefs Conference | Substance Abuse Rehabilitation Facility | 201 1st Ave, Fairbanks, AK 99701-4848 | 2011-07-15 |
| 1386817237 | Fairbanks Native Association | Substance Abuse Rehabilitation Facility | 2550 Lawlor Rd, Fairbanks, AK 99709-6458 | 2008-04-10 |
| 1154594216 | Fairbanks Native Association | Substance Abuse Rehabilitation Facility | 3100 S Cushman St, Fairbanks, AK 99701-7516 | 2008-04-10 |
| 1982877353 | Old Minto Family Recovery Camp | Substance Abuse Rehabilitation Facility | 122 1st Ave, Fairbanks, AK 99701-4803 | 2008-04-08 |
| 1578736211 | Fairbanks Native Association | Substance Abuse Rehabilitation Facility | 1027 Evergreen St, Fairbanks, AK 99709-4306 | 2008-04-02 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.