Healthcare Provider Details

I. General information

NPI: 1326902891
Provider Name (Legal Business Name): EXCEPTIONAL CASE MANAGEMENT, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/10/2025
Last Update Date: 12/10/2025
Certification Date: 12/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5759 WINCHESTER PL 5759 WINCHESTER PL
LITHONIA GA
30038-4085
US

IV. Provider business mailing address

5759 WINCHESTER PL 5759 WINCHESTER PL
LITHONIA GA
30038-4085
US

V. Phone/Fax

Practice location:
  • Phone: 404-307-3388
  • Fax: 770-802-4872
Mailing address:
  • Phone: 404-307-3388
  • Fax: 770-802-4872

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name: SONNY K FYNEFACE
Title or Position: CASE MANAGER
Credential: MSW
Phone: 404-307-3388