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Organization
IMMEDIATE CARE, INC
Active
Organization
IMMEDIATE CARE, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MIRASOL MIRASOL ISLA (DIRECTOR OF FINANCE)
(907) 336-3365
Entity
Organization
Contact information
Practice address
6311 DEBARR ROAD, ANCHORAGE, AK 99504
(907) 336-3365
(907) 929-5661
Mailing address
PO BOX 103913, ANCHORAGE, AK 99510-3913
(907) 336-3365
(907) 929-5661
Taxonomy
Speciality
Code
Description
License number
State
251X00000X
Supports Brokerage Agency
Primary
714562
AK
261QA0600X
Adult Day Care Clinic/Center
714562
AK
385H00000X
Respite Care
714562
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
CMG020
—
AK
05
—
CMG472
—
AK
05
—
HC0202
—
AK
05
—
HC02021
—
AK
05
—
HC02022
—
AK
05
—
PCG201
—
AK
05
—
PCG2021
—
AK
05
—
PCG2031
—
AK
Enumeration date
02/28/2007
Last updated
05/14/2008
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