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General NPI Number Information
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NPI Number | 1043015241
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Entity Type | Organization
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Legal Business Name | PERFORMANCE DRIVEN CASE MANAGEMENT, LLC
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Dates
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Enumeration Date | 02/13/2025
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Last Update Date | 02/13/2025
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Provider Practice Location Address
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Address Line | 811 WALSINGHAM WAY
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City | VALRICO
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State | FL
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Zip | 33594-4014
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Country | US
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Telephone | 813-480-9762
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Fax | 855-753-0076
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Provider Business Mailing Address
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Address Line | 811 WALSINGHAM WAY
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City | VALRICO
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State | FL
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Zip | 33594-4014
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Country | US
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Telephone | 866-531-2411
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Fax | 855-753-0076
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Authorized Official
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Title or Position | OWNER/ CEO
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Name | MRS. TRACEY YVETTE CANTY
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Credential | RN
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Telephone | 866-531-2411
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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