Healthcare Provider Details

I. General information

NPI: 1134054414
Provider Name (Legal Business Name): SIGNATURE CARE MANAGEMENT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/16/2026
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 WALDEN WALK DR
STONE MOUNTAIN GA
30088-2756
US

IV. Provider business mailing address

105 WALDEN WALK DR
STONE MOUNTAIN GA
30088-2756
US

V. Phone/Fax

Practice location:
  • Phone: 202-294-4522
  • Fax:
Mailing address:
  • Phone: 202-294-4522
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name: KATRICE DENISE PRICE
Title or Position: OWNER
Credential:
Phone: 202-294-4522