SRC Case Management Group

Primary specialty

Case Management AgencyTaxonomy code 251B00000X

License

1014463 Issued in AK

Legal business name

SRC CASE MANAGEMENT GROUP

Practice address

6033 N Sitze Rd
Wasilla, AK 99623-9078

Phone

(907) 250-6648

NPI assigned

Dec 31, 2014

Last updated

Dec 31, 2014By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Irina Geddes

Title

President

Phone

(907) 250-6648

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1419984000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1419984000000",
    "number": "1558759340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2521 E MOUNTAIN VILLAGE DR",
            "address_2": "SUITE B",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996547373",
            "telephone_number": "907-250-6605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6033 N SITZE RD",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996239078",
            "telephone_number": "907-250-6648"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SRC CASE MANAGEMENT GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-31",
        "last_updated": "2014-12-31",
        "status": "A",
        "authorized_official_last_name": "GEDDES",
        "authorized_official_first_name": "IRINA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "907-250-6648"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "AK",
            "license": "1014463",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Case Management Agency in Wasilla, AK
• Providers in Wasilla, AK by specialty
• Case Management Agency in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.