Provider Demographics
NPI:1568065431
Name:A2A CARE COORDINATION, LLC
Entity Type:Organization
Organization Name:A2A CARE COORDINATION, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ALISHA
Authorized Official - Middle Name:LYNNE
Authorized Official - Last Name:RUKOVISHNIKOFF
Authorized Official - Suffix:
Authorized Official - Credentials:CMA
Authorized Official - Phone:907-570-2333
Mailing Address - Street 1:7749 CHERRYWOOD CIR
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99507-2973
Mailing Address - Country:US
Mailing Address - Phone:907-570-2333
Mailing Address - Fax:
Practice Address - Street 1:7749 CHERRYWOOD CIR
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99507-2973
Practice Address - Country:US
Practice Address - Phone:907-570-2333
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-20
Last Update Date:2020-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Single Specialty