NORTH COUNTRY MEDICAL, LLC (NPI# 1790236578) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790236578 |
| Entity Type | Organization |
| Organization Name | NORTH COUNTRY MEDICAL, LLC |
| Practice Address |
626 2nd St Suite 201b Fairbanks AK 99701-3466 |
| Mailing Address |
2500 Zion Ct Anchorage AK 99507-2151 |
| Practice Telephone | 9076870722 |
| Enumeration Date | 2016-10-17 |
| Last Update Date | 2016-10-17 |
| Authorized Official Name | PAUL WOOD FINCH JR. (ORGANIZER) |
| Authorized Official Telephone | 9076870722 |
| Authorized Official Credential | P.A. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 324500000X | Substance Abuse Rehabilitation Facility | PADA185 | AK | Residential Treatment Facilities |
| Street Address |
626 2ND ST SUITE 201B |
| City | FAIRBANKS |
| State | AK |
| Zip Code | 99701-3466 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043401631 | Jennifer Hood | Counselor | 626 2nd St, Fairbanks, AK 99701-3405 | 2007-08-07 |
| 1164800363 | Dallas Norman Lpc LLC | Counselor | 626 2nd St, Suite 101a, Fairbanks, AK 99701-3466 | 2015-05-08 |
| 1497946081 | Lorraine Landers | Counselor | 626 2nd St, Suite 303, Fairbanks, AK 99701-3466 | 2007-08-07 |
| 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 |
| 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 |
| 1982876629 | Fairbanks Native Association | Substance Abuse Rehabilitation Facility | 2550 Lawlor Rd, Fairbanks, AK 99709-6458 | 2008-04-01 |
| Find all providers in FAIRBANKS | ||||
Please comment or provide details below to improve the information on NORTH COUNTRY MEDICAL, LLC.
| 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.