Provider Demographics
NPI:1548452477
Name:STONE SOUP GROUP
Entity type:Organization
Organization Name:STONE SOUP GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LYNN
Authorized Official - Middle Name:F
Authorized Official - Last Name:CASWELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:907-561-3701
Mailing Address - Street 1:3350 COMMERCIAL DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99501-3023
Mailing Address - Country:US
Mailing Address - Phone:907-561-3701
Mailing Address - Fax:907-561-3702
Practice Address - Street 1:3350 COMMERCIAL DR
Practice Address - Street 2:SUITE 100
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99501-3023
Practice Address - Country:US
Practice Address - Phone:907-561-3701
Practice Address - Fax:907-561-3702
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-14
Last Update Date:2007-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management