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General NPI Number Information
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NPI Number | 1407027139
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Entity Type | Organization
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Legal Business Name | CASE MANAGEMENT SERVICES LLC
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Dates
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Enumeration Date | 03/20/2008
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Last Update Date | 08/20/2015
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Provider Practice Location Address
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Address Line | 2504 NEWTON DRIVE
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City | STATESVILLE
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State | NC
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Zip | 28677-3053
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Country | US
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Telephone | 704-871-2955
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Fax | 704-871-2957
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Provider Business Mailing Address
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Address Line | 2504 NEWTON DR
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City | STATESVILLE
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State | NC
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Zip | 28677-3053
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Country | US
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Telephone | 704-871-2955
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Fax | 704-871-2957
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Authorized Official
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Title or Position | MEMBER/MANAGER OF CLINICAL SERVICES
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Name | JERALD THOMAS SNOW
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Credential |
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Telephone | 704-871-2955
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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 | C200802200738
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number |
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License Number State |
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