Provider Demographics
NPI:1740558964
Name:ALASKA COMMUNITY CARE LLC
Entity Type:Organization
Organization Name:ALASKA COMMUNITY CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANALISA
Authorized Official - Middle Name:K
Authorized Official - Last Name:SELDEN
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:907-953-0098
Mailing Address - Street 1:246 RIVER WATCH DR
Mailing Address - Street 2:
Mailing Address - City:SOLDOTNA
Mailing Address - State:AK
Mailing Address - Zip Code:99669-7354
Mailing Address - Country:US
Mailing Address - Phone:907-953-0098
Mailing Address - Fax:907-260-4827
Practice Address - Street 1:246 RIVER WATCH DR
Practice Address - Street 2:
Practice Address - City:SOLDOTNA
Practice Address - State:AK
Practice Address - Zip Code:99669-7354
Practice Address - Country:US
Practice Address - Phone:907-953-0098
Practice Address - Fax:907-260-4827
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-01
Last Update Date:2011-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Multi-Specialty