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General NPI Number Information
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NPI Number | 1942640941
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Entity Type | Organization
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Legal Business Name | CONNECT CARE
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Dates
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Enumeration Date | 07/05/2013
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Last Update Date | 07/05/2013
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Provider Practice Location Address
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Address Line | 35555 SPUR HWY PMB 167
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City | SOLDOTNA
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State | AK
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Zip | 99669
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Country | US
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Telephone | 907-420-0803
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Fax |
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Provider Business Mailing Address
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Address Line | 35555 SPUR HWY PMB 167
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City | SOLDOTNA
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State | AK
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Zip | 99669
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | SOLE PROPRIETOR
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Name | JESSICA MARIE DRURY
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Credential |
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Telephone | 907-420-0803
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number | 950066
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License Number State | AK
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