Provider Demographics
NPI:1649445065
Name:BOREAL FUTURES, LLC
Entity type:Organization
Organization Name:BOREAL FUTURES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:MS
Authorized Official - First Name:TERESA
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:FIROR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:907-479-5454
Mailing Address - Street 1:3875 GEIST RD STE E
Mailing Address - Street 2:PBM 312
Mailing Address - City:FAIRBANKS
Mailing Address - State:AK
Mailing Address - Zip Code:99709-3549
Mailing Address - Country:US
Mailing Address - Phone:907-388-9730
Mailing Address - Fax:
Practice Address - Street 1:9 TRINIDAD DR
Practice Address - Street 2:
Practice Address - City:FAIRBANKS
Practice Address - State:AK
Practice Address - Zip Code:99709-3121
Practice Address - Country:US
Practice Address - Phone:907-388-9730
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-27
Last Update Date:2008-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management