Organization
MAD DOGS & ENGLISHMEN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANNY KILANOWSKI (ADMINISTRATOR)
(907) 354-4627
Entity
Organization
Contact information
Practice address
5900 W LOCKSLEY LOOP, WASILLA, AK 99623-0837
(907) 357-7478
(907) 357-7428
Mailing address
7362 W PARKS HWY, WASILLA, AK 99623-9300
(907) 357-7478
(907) 357-7428
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
741871
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1770737546
—
AK
Enumeration date
11/12/2014
Last updated
11/12/2014
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