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Organization

SPROUT FAMILY SERVICES, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JILLIAN LUSH (EXECUTIVE DIRECTOR)
(907) 235-6044
Entity
Organization

Contact information

Practice address
3691 BEN WALTERS LN STE 4, HOMER, AK 99603-7750
(907) 235-6044
(907) 235-2644
Mailing address
3691 BEN WALTERS LN STE 4, HOMER, AK 99603-7750
(907) 235-6044
(907) 235-2644

Taxonomy

Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
251C00000X
Developmentally Disabled Services Day Training Agency

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
CMG117
AK
05
TC2625
AK
Enumeration date
03/23/2007
Last updated
12/05/2011
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