Organization
SRC CASE MANAGEMENT GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
IRINA GEDDES (PRESIDENT)
(907) 250-6648
Entity
Organization
Contact information
Practice address
6033 N SITZE RD, WASILLA, AK 99623-9078
(907) 250-6648
Mailing address
2521 E MOUNTAIN VILLAGE DR, SUITE B, WASILLA, AK 99654-7373
(907) 250-6605
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
1014463
AK
Other
Enumeration date
12/31/2014
Last updated
12/31/2014
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