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General NPI Number Information
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NPI Number | 1407270168
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Entity Type | Organization
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Legal Business Name | SUSIE DECKER CASE MANAGEMENT SERVICES LLC
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Dates
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Enumeration Date | 02/14/2014
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Last Update Date | 02/14/2014
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Provider Practice Location Address
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Address Line | 1208 LYNX RD SW
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City | BURLINGTON
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State | KS
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Zip | 66839-9249
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Country | US
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Telephone | 620-203-0344
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Fax | 785-260-9047
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Provider Business Mailing Address
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Address Line | 1208 LYNX RD SW
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City | BURLINGTON
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State | KS
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Zip | 66839-9249
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Country | US
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Telephone | 620-203-0344
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Fax | 785-260-9047
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Authorized Official
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Title or Position | OWNER/CASE MANAGER
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Name | SUSAN R BECKER
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Credential |
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Telephone | 620-203-0344
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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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