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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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