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General NPI Number Information
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NPI Number | 1295951697
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Entity Type | Organization
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Legal Business Name | MOXIE CARE
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Dates
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Enumeration Date | 04/17/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 44905 CARVER DR
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City | KENAI
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State | AK
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Zip | 99611-6742
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Country | US
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Telephone | 907-260-7442
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Fax |
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Provider Business Mailing Address
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Address Line | 44905 CARVER DRIVE
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City | KENAI
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State | AK
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Zip | 99611
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Country | US
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Telephone | 907-260-7442
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DEBORAH SUE MCCARTHY
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Credential | RN
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Telephone | 907-260-7442
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number | 10770
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License Number State | AK
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