| Set Free Alaska, Inc. | |
|
7010 E Bogard Rd Bldg 1 Wasilla AK 99654-4711 | |
| (907) 373-4732 | |
| (907) 746-4749 |
| Full Name | Set Free Alaska, Inc. |
|---|---|
| Speciality | Substance Abuse Rehabilitation Facility |
| Location | 7010 E Bogard Rd Bldg 1, Wasilla, Alaska |
| Authorized Official Name and Position | Joyce E Stein (CHIEF FINANCIAL OFFICER) |
| Authorized Official Contact | 9079821054 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Set Free Alaska, Inc. Po Box 876741 Wasilla AK 99687-6741 Ph: (907) 373-4732 | Set Free Alaska, Inc. 7010 E Bogard Rd Bldg 1 Wasilla AK 99654-4711 Ph: (907) 373-4732 |
| NPI Number | 1073841789 |
|---|---|
| Provider Enumeration Date | 11/19/2009 |
| Last Update Date | 08/20/2024 |
| Certification Date | 08/19/2024 |
| Medicare PECOS PAC ID | 2668899204 |
|---|---|
| Medicare Enrollment ID | O20200827003677 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073841789 | NPI | - | NPPES |
| 1706868 | Medicaid | AK | |
| 1679665 | Medicaid | AK | |
| 1702627 | Medicaid | AK | |
| 602-208-20052 | Other | AK | STATE OF ALASKA GRANT |
| 1585308 | Medicaid | AK | |
| 602-239-20011 | Other | AK | STATE OF ALASKA GRANT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Secondary |
| 324500000X | Substance Abuse Rehabilitation Facility | (* (Not Available)) | Primary |
| Provider Name | Amanda L Zeppa |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1750679924 PECOS PAC ID: 4486071172 Enrollment ID: I20200826001675 |
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