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General NPI Number Information
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NPI Number | 1528461449
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Entity Type | Organization
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Legal Business Name | CASE MANAGEMENT CONNECTION OF THE TRIAD, INC.
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Dates
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Enumeration Date | 10/06/2014
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Last Update Date | 10/06/2014
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Provider Practice Location Address
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Address Line | 1897 SMITH FARM RD
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City | THOMASVILLE
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State | NC
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Zip | 27360-7520
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Country | US
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Telephone | 336-803-5408
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Fax | 336-475-8170
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Provider Business Mailing Address
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Address Line | PO BOX 519
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City | THOMASVILLE
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State | NC
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Zip | 27361-0519
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Country | US
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Telephone | 336-803-5408
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Fax | 336-475-8170
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Authorized Official
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Title or Position | PRESIDENT
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Name | SHELIA H WARD
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Credential | RN
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Telephone | 336-803-5408
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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 | 088569
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License Number State | NC
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