Organization
LIGHTHOUSE CARE COORDINATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SANDRA MINORA GOLLEY (ADMINISTRATOR)
(907) 562-4288
Entity
Organization
Contact information
Practice address
3325 E 17TH AVE, ANCHORAGE, AK 99508-3322
(907) 562-4288
Mailing address
3325 E 17TH AVE, ANCHORAGE, AK 99508-3322
(907) 562-4288
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Enumeration date
05/04/2012
Last updated
05/04/2012
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