Provider Demographics
NPI:1992329304
Name:MAKING A DIFFERENCE CARE COORDINATION, LLC
Entity type:Organization
Organization Name:MAKING A DIFFERENCE CARE COORDINATION, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:ORTIZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:907-952-3966
Mailing Address - Street 1:PO BOX 112107
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99511-2107
Mailing Address - Country:US
Mailing Address - Phone:907-952-3966
Mailing Address - Fax:844-561-6911
Practice Address - Street 1:13212 ELMHURST DR
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99515-4018
Practice Address - Country:US
Practice Address - Phone:190-795-2396
Practice Address - Fax:844-561-6911
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-01
Last Update Date:2020-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Single Specialty