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General NPI Number Information
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NPI Number | 1023927084
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Entity Type | Organization
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Legal Business Name | KELLY CASE MANAGEMENT SERVICES LLC
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Dates
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Enumeration Date | 09/04/2026
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Last Update Date | 09/04/2026
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Provider Practice Location Address
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Address Line | REMOTE
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City | REXBURG
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State | ID
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Zip | 83440
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Country | US
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Telephone | 208-410-8695
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Fax |
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Provider Business Mailing Address
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Address Line | 1999 S 25TH E # 1011
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City | AMMON
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State | ID
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Zip | 83406-5710
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Country | US
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Telephone | 208-410-8695
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Fax |
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Authorized Official
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Title or Position | OWNER/FOUNDER
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Name | CODY J. KELLY
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Credential |
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Telephone | 208-410-8695
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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