Basic Information
Provider Information
NPI: 1891860565
EntityType: 2
ReplacementNPI:  
OrganizationName: JOB READY, INC
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName: READY CARE
OtherOrganizationType: 3
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 600 BARROW ST
Address2: SUITE 404
City: ANCHORAGE
State: AK
PostalCode: 995013631
CountryCode: US
TelephoneNumber: 9072583498
FaxNumber: 9072790171
Practice Location
Address1: 357 E PARKS HWY
Address2:  
City: WASILLA
State: AK
PostalCode: 996547040
CountryCode: US
TelephoneNumber: 9073575627
FaxNumber: 9073575628
Other Information
ProviderEnumerationDate: 11/21/2006
LastUpdateDate: 08/22/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: SANFORD
AuthorizedOfficialFirstName: STEVEN
AuthorizedOfficialMiddleName: B.
AuthorizedOfficialTitleorPosition: EXECUTIVE DIRECTOR
AuthorizedOfficialTelephone: 9072583498
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix: MR.
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
3747P1801X272340AKY193400000X MULTIPLE SINGLE SPECIALTY GROUPNursing Service Related ProvidersTechnicianPersonal Care Attendant

ID Information
IDTypeStateIssuerDescription
PCG60005AK MEDICAID


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