Provider Demographics
NPI:1013748094
Name:EASLEY CARE LLC
Entity type:Organization
Organization Name:EASLEY CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CARE COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:MIKKI
Authorized Official - Middle Name:
Authorized Official - Last Name:EASLEY
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:907-290-2186
Mailing Address - Street 1:PO BOX 110481
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99511-0481
Mailing Address - Country:US
Mailing Address - Phone:907-290-2186
Mailing Address - Fax:
Practice Address - Street 1:13250 BADGER LN
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99516-3067
Practice Address - Country:US
Practice Address - Phone:907-290-2186
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-12
Last Update Date:2024-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management