Healthcare Provider Details

I. General information

NPI: 1164961090
Provider Name (Legal Business Name): CONTINUITY CASE MANAGEMENT SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/12/2017
Last Update Date: 02/12/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24801 5 MILE RD 12
REDFORD MI
48239-3655
US

IV. Provider business mailing address

20615 FENKELL ST 231052
DETROIT MI
48223-3778
US

V. Phone/Fax

Practice location:
  • Phone: 866-550-6629
  • Fax: 248-607-6757
Mailing address:
  • Phone: 866-550-6629
  • Fax: 248-607-6756

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. SUPRENIA THOMAS
Title or Position: DIRECTOR OF PROFESSIONAL SERVICES
Credential:
Phone: 866-550-6629