Organization
PIVOTAL CARE PARTNERSHIP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRUCE HAVELOCK (DIRECTOR)
(907) 375-2025
Entity
Organization
Contact information
Practice address
2925 DEBARR RD STE 199, ANCHORAGE, AK 99508-2959
(907) 632-5057
Mailing address
PO BOX 90812, ANCHORAGE, AK 99509-0812
(907) 375-2025
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1588968945
—
AK
Enumeration date
10/19/2020
Last updated
12/30/2020
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