Provider Demographics
NPI:1912445446
Name:NORTHERN LIGHTS CARE COORDINATION
Entity Type:Organization
Organization Name:NORTHERN LIGHTS CARE COORDINATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CARE COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:D
Authorized Official - Last Name:DICK
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:907-440-2038
Mailing Address - Street 1:4111 E 20TH AVE UNIT 7
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99508-3562
Mailing Address - Country:US
Mailing Address - Phone:907-222-2639
Mailing Address - Fax:907-222-2585
Practice Address - Street 1:4111 E 20TH AVE UNIT 7
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-3562
Practice Address - Country:US
Practice Address - Phone:907-222-2639
Practice Address - Fax:907-222-2585
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-03
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management