MEDICARE: SHIRELLES PERSON CENTERED CASE MANAGEMENT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163WC0400X	Case Management Registered Nurse
2	251B00000X	Case Management Agency

General Provider Information

NPI Number	:	1477268688
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SHIRELLES PERSON CENTERED CASE MANAGEMENT

Provider Business Mailing Address
First Line	:	5258 MADDEN LN
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77048-2724
Country	:	US
Telephone Number	:	281-901-8485
Fax Number	:

Provider Business Practice Location Address
First Line	:	5258 MADDEN LN
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77048-2724
Country	:	US
Telephone Number	:	281-901-8485
Fax Number	:

Authorized Official
Title or Position	:	OWNER/DIRECTOR
Name	:	SHIRELLE COLLINS WASHINGTON
Credential	:	RN
Telephone Number	:	281-901-8485

Provider Enumeration Date	:	01/23/2023
Last Update Date	:	05/22/2023

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