Provider Demographics
NPI:1235558016
Name:ALASKA FULL CIRCLE COUNSELING SOLUTIONS LLC
Entity Type:Organization
Organization Name:ALASKA FULL CIRCLE COUNSELING SOLUTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:
Authorized Official - Last Name:VEREIDE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:907-357-7962
Mailing Address - Street 1:133 E SWANSON AVE
Mailing Address - Street 2:
Mailing Address - City:WASILLA
Mailing Address - State:AK
Mailing Address - Zip Code:99654-7025
Mailing Address - Country:US
Mailing Address - Phone:907-864-0560
Mailing Address - Fax:907-864-0564
Practice Address - Street 1:133 E SWANSON AVE
Practice Address - Street 2:
Practice Address - City:WASILLA
Practice Address - State:AK
Practice Address - Zip Code:99654-7025
Practice Address - Country:US
Practice Address - Phone:907-864-0560
Practice Address - Fax:907-864-0564
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-09
Last Update Date:2014-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health