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Organization
NORTHWEST INDEPENDENCE CARE LLC
Active
Organization
NORTHWEST INDEPENDENCE CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARY CATHERINE EVANS LCSW (CARE COORDINATOR ADMINISTRATOR)
(907) 575-8501
Entity
Organization
Contact information
Practice address
2701 KEMPTON HILLS DR, ANCHORAGE, AK 99516-2749
(907) 575-8501
(907) 644-0601
Mailing address
PO BOX 110382, ANCHORAGE, AK 99511-0382
(907) 575-8501
(907) 644-0601
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
987297
AK
Other
Enumeration date
01/31/2014
Last updated
01/31/2014
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