Provider Demographics
NPI:1598212672
Name:CARE COORDINATION RESOURCE
Entity Type:Organization
Organization Name:CARE COORDINATION RESOURCE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTRATOR/CARECOORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:LAURIE
Authorized Official - Middle Name:
Authorized Official - Last Name:DEAKINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:907-299-5544
Mailing Address - Street 1:PO BOX 407
Mailing Address - Street 2:
Mailing Address - City:HOMER
Mailing Address - State:AK
Mailing Address - Zip Code:99603-0407
Mailing Address - Country:US
Mailing Address - Phone:907-299-5544
Mailing Address - Fax:
Practice Address - Street 1:4604 TAMARA ST
Practice Address - Street 2:
Practice Address - City:HOMER
Practice Address - State:AK
Practice Address - Zip Code:99603-7308
Practice Address - Country:US
Practice Address - Phone:907-299-5544
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-06
Last Update Date:2016-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK1037235251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management