PROVIDENCE HEALTH & SERVICES WASHINGTON NPI 1407945389

NPI Information

NPI: 1407945389
Provider Name: PROVIDENCE HEALTH & SERVICES WASHINGTON

Doing Business As: CRISIS RECOVERY CENTER

Classification: Community Based Residential Treatment Facility, Mental Illness - 320800000X
Entity Type: Organization
Address:
3760 PIPER ST
SUITE LL 139
ANCHORAGE, AK
ZIP 99508
Phone: (907) 563-5006
Get Directions

PROVIDENCE HEALTH & SERVICES WASHINGTON is a community based residential treatment facility mental illness in Anchorage, AK. The provider is a home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. PROVIDENCE HEALTH & SERVICES WASHINGTON NPI is 1407945389. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Crisis Recovery Center.

The provider's business location address is:

3760 PIPER ST
SUITE LL 139
ANCHORAGE, AK
ZIP 99508-665
Phone: (907) 563-5006
Fax: (907) 563-3217

The provider's authorized official is Donald Anderson .
The authorized official title is Director Reimbursment Admin and has the following contact phone number (425) 525-5392.

The enumeration date for this NPI number is 10/11/2006 and was last updated on 9/1/2017.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	2084P0800X	Psychiatry & Neurology	Psychiatry			No
2	2084P0802X	Psychiatry & Neurology	Addiction Psychiatry			No
3	322D00000X	Residential Treatment Facility, Emotionally Disturbed Children		512146	ALASKA	No
4	363LP0808X	Nurse Practitioner	Psychiatric/Mental Health			No
5	320800000X	Community Based Residential Treatment Facility, Mental Illness		NOT NUMBERED	ALASKA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1021061	MEDICAID	ALASKA
2	1584965	MEDICAID	ALASKA
3	MH3715	MEDICAID	ALASKA
4	K0000WCHHH	MEDICARE PIN
5	512146	OTHER	ALASKA	STATE OF ALASKA COMMUNITY CARE LICENSE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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