Organization
LINKS MAT-SU PARENT RESOURCE CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. FREDERICK COATES PENNINGTON IV (EXECUTIVE DIRECTOR)
(907) 373-3631
Entity
Organization
Contact information
Practice address
777 N CRUSEY ST STE A101, WASILLA, AK 99654-7100
(907) 373-3632
(907) 373-3620
Mailing address
777 N CRUSEY ST STE A101, WASILLA, AK 99654-7100
(907) 373-3632
(907) 373-3620
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
06/07/2019
Last updated
06/07/2019
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