Organization
RAVEN CARE, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BROOK CONNOLLY (OWNER/ADMINISTRATOR)
(907) 360-0921
Entity
Organization
Contact information
Practice address
13424 ALPWEG, ANCHORAGE, AK 99516-6974
(907) 345-9400
Mailing address
PO BOX 110881, ANCHORAGE, AK 99511-0881
(907) 345-9400
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
1200
AK
Other
Enumeration date
10/02/2013
Last updated
10/02/2013
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