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General NPI Number Information
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NPI Number | 1497387179
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Entity Type | Organization
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Legal Business Name | 360 CASE MANAGEMENT LLC
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Dates
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Enumeration Date | 02/10/2020
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Last Update Date | 03/16/2024
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Provider Practice Location Address
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Address Line | 35 VARDEN DR STE A
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City | AIKEN
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State | SC
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Zip | 29803-5275
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Country | US
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Telephone | 803-226-0236
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Fax | 803-226-0335
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Provider Business Mailing Address
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Address Line | 35 VARDEN DR STE A
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City | AIKEN
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State | SC
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Zip | 29803-5275
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Country | US
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Telephone | 803-226-0236
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Fax | 803-226-0335
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Authorized Official
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Title or Position | OWNER
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Name | JUANETHEA BRYANT-LORD
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Credential |
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Telephone | 803-226-0236
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 133NN1002X
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Taxonomy Name | Nutrition Education Nutritionist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 163WC0400X
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Taxonomy Name | Case Management Registered Nurse
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 171400000X
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Taxonomy Name | Health & Wellness Coach
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License Number |
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License Number State |
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Taxonomy #5
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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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Taxonomy #6
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number |
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License Number State |
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Taxonomy #7
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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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