Organization
GRACE R, LLC
Active
Other names
GRACE R
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JUANITA SERENA ELLIOTT CARE COORDINATOR (CARE COORDINATOR)
(907) 569-5033
Entity
Organization
Contact information
Practice address
1626 DOLINA CIR, ANCHORAGE, AK 99508-3509
(907) 569-5033
Mailing address
PO BOX 141795, ANCHORAGE, AK 99514-1795
(907) 569-5033
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
937341
AK
Other
Enumeration date
12/29/2009
Last updated
12/29/2009
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