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NPI 1174288039

NPI 1174288039 : INFINITY CASE MANAGEMENT, LLC : LOCUST GROVE, GA

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General NPI Number Information
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    NPI Number           |    1174288039
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    Entity Type          |    Organization 
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    Legal Business Name  |    INFINITY CASE MANAGEMENT, LLC 
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Dates
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    Enumeration Date     |    11/05/2021
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    Last Update Date     |    11/05/2021
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Provider Practice Location Address
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    Address Line         |    7005 BECCA LN 
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    City                 |    LOCUST GROVE
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    State                |    GA
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    Zip                  |    30248-4385
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    Country              |    US
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    Telephone            |    478-491-2732
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    7005 BECCA LN 
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    City                 |    LOCUST GROVE
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    State                |    GA
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    Zip                  |    30248-4385
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    Country              |    US
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    Telephone            |    
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    Fax                  |    
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Authorized Official
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    Title or Position    |    OWNER/ADMINISTRATOR
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    Name                 |    MRS. YATISHA  ROBERSON 
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    Credential           |    
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    Telephone            |    478-491-2732
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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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