Healthcare Provider Details

I. General information

NPI: 1053233205
Provider Name (Legal Business Name): AZURE RECOVERY CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/29/2026
Last Update Date: 07/29/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11231 VIA APPIA
ANCHORAGE AK
99515-2902
US

IV. Provider business mailing address

11231 VIA APPIA
ANCHORAGE AK
99515-2902
US

V. Phone/Fax

Practice location:
  • Phone: 907-727-8045
  • Fax:
Mailing address:
  • Phone: 907-727-8045
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State

VIII. Authorized Official

Name: QAMAR A SCEGO
Title or Position: OWNER
Credential:
Phone: 480-277-0283