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FAIRBANKS NATIVE ASSOCIATION
NPI 1134764913
Substance Abuse Rehabilitation Facility in Fairbanks, AK

Active since November 15, 2019CLIA 02D2042948 · Waiver
650 YOUNKER CT, FAIRBANKS, AK 99701(907) 456-1053(907) 452-1001 Get Directions Write a Review

NPPES record last updated: November 15, 2019. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Fairbanks Native Association NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

FAIRBANKS NATIVE ASSOCIATION (NPI 1134764913), doing business as Gateway To Recovery, is a healthcare organization registered as a substance abuse rehabilitation facility in Fairbanks, Alaska and active in the NPI registry since November 2019. The organization holds a CLIA Waiver certificate valid through June 21, 2028 and lists Perry Ahsogeak, Behavioral Health Director, as its authorized official.

NPPES Registry Identity

NPI1134764913
Entity TypeOrganization
Primary Taxonomy324500000X
Legal Business NameFAIRBANKS NATIVE ASSOCIATION
Location Address650 YOUNKER CTFairbanks, AK 99701-7586
Mailing Address315 Wendell AveFairbanks, AK 99701-4837 · (907) 452-6251 · Fax (907) 452-1001
Phone(907) 456-1053
Fax(907) 452-1001
Organization SubpartNo
Authorized OfficialPerry AhsogeakBehavioral Health Director · (907) 452-6251
Enumeration DateNovember 15, 2019
✔ NPI 1134764913 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySubstance Abuse Rehabilitation FacilityResidential Treatment Facilities
Taxonomy Code324500000X
Definition

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.

650 YOUNKER CT, Fairbanks, AK 99701
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Other Names 1

Doing Business AsGateway To Recovery

Other Identifiers 1

Medicaid1696799AK

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 02D2042948

Fairbanks Native Association · Fairbanks, AK
Active · expires Jun 21, 2028
CLIA Number02D2042948
Laboratory TypeAlcohol/Drug Rehab Center
Certificate Effective DateJune 22, 2026
Certificate Expiration DateJune 21, 2028
Laboratory DirectorHarry Conway
Laboratory Phone(907) 405-8257
Laboratory LocationFairbanks Native Association605 Hughes Ave, Fairbanks, AK 99701
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

BRIDGET WILKERSON CDC I
Counselor (Addiction (Substance Use Disorder))
650 YOUNKER CT
FAIRBANKS, AK 99701
Fairbanks North Star Borough (907) 452-8251
TAMARA LU THOMPSON LPN
Licensed Practical Nurse
650 YOUNKER CT
FAIRBANKS, AK 99701
Fairbanks North Star Borough (907) 456-1053
MRS. CYNTHIA LU BELLE KELLEY RN
Registered Nurse (Addiction (Substance Use Disorder))
650 YOUNKER CT
FAIRBANKS, AK 99701
Fairbanks North Star Borough (907) 456-1053
JODY TATE RN
Registered Nurse (Addiction (Substance Use Disorder))
650 YOUNKER CT
FAIRBANKS, AK 99701
Fairbanks North Star Borough (907) 456-1053
ALINA CUSHING RN
Registered Nurse
650 YOUNKER CT
FAIRBANKS, AK 99701
Fairbanks North Star Borough (907) 456-1053
MS. MARGARET LOUISE KUGZRUK LMSW
Social Worker (Clinical)
650 YOUNKER CT
FAIRBANKS, AK 99701
Fairbanks North Star Borough (907) 456-1053
SHARON ELEMENTO EGANA-CABOLIS LPN
Licensed Practical Nurse
650 YOUNKER CT
FAIRBANKS, AK 99701
Fairbanks North Star Borough (907) 456-1053
SARA BURLEY
Registered Nurse
650 YOUNKER CT
FAIRBANKS, AK 99701
Fairbanks North Star Borough (907) 456-1053

Frequently Asked Questions

What is FAIRBANKS NATIVE ASSOCIATION's NPI number?

The NPI number assigned to this healthcare provider is 1134764913, enumerated as an "organization" on November 15, 2019.

Where is the provider located?

The provider is located at 650 YOUNKER CT FAIRBANKS, AK 99701 and the phone number is (907) 456-1053.

What is the provider's specialty?

Substance Abuse Rehabilitation Facility with taxonomy code 324500000X.

What insurance does FAIRBANKS NATIVE ASSOCIATION accept?

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.