Provider Demographics
NPI:1235770298
Name:GREATER WORKS CARING CENTER, LLC
Entity Type:Organization
Organization Name:GREATER WORKS CARING CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:
Authorized Official - First Name:CAROLYN
Authorized Official - Middle Name:
Authorized Official - Last Name:COOPER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:907-374-7076
Mailing Address - Street 1:3550 AIRPORT WAY STE 203
Mailing Address - Street 2:
Mailing Address - City:FAIRBANKS
Mailing Address - State:AK
Mailing Address - Zip Code:99709-4772
Mailing Address - Country:US
Mailing Address - Phone:907-374-7076
Mailing Address - Fax:
Practice Address - Street 1:3550 AIRPORT WAY STE 203
Practice Address - Street 2:
Practice Address - City:FAIRBANKS
Practice Address - State:AK
Practice Address - Zip Code:99709-4772
Practice Address - Country:US
Practice Address - Phone:907-374-7076
Practice Address - Fax:907-374-7078
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-01
Last Update Date:2019-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities