| Providence Crisis Recovery Center | |
|
3760 Piper St Suite Ll 139 Anchorage AK 99508-4665 | |
| (907) 563-5006 | |
| (907) 563-3217 |
| Full Name | Providence Crisis Recovery Center |
|---|---|
| Speciality | Community Based Residential Treatment Facility, Mental Illness |
| Location | 3760 Piper St, Anchorage, Alaska |
| Authorized Official Name and Position | Donald Anderson (ASSISTANT SECRETARY OF ENROLLMENTS) |
| Authorized Official Contact | 4255255392 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Providence Crisis Recovery Center Po Box 4105 Portland OR 97208-4105 Ph: (866) 907-1068 | Providence Crisis Recovery Center 3760 Piper St Suite Ll 139 Anchorage AK 99508-4665 Ph: (907) 563-5006 |
| NPI Number | 1407945389 |
|---|---|
| Provider Enumeration Date | 10/11/2006 |
| Last Update Date | 09/25/2024 |
| Certification Date | 09/19/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407945389 | NPI | - | NPPES |
| 1021061 | Medicaid | AK | |
| 1584965 | Medicaid | AK | |
| MH3715 | Medicaid | AK | |
| 512146 | Other | AK | STATE OF ALASKA COMMUNITY CARE LICENSE |
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