Organization
LIFE ENRICHMENT SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MARY S JACKS MSW (CARE COORDINATOR)
(907) 868-3562
Entity
Organization
Contact information
Practice address
2340 SENTRY DR APT 805, ANCHORAGE, AK 99507-5344
(907) 868-3562
(907) 868-3562
Mailing address
PO BOX 232245, ANCHORAGE, AK 99523-2245
(907) 868-3562
(907) 868-3562
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
902213
AK
Other
Enumeration date
04/06/2007
Last updated
12/22/2008
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