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General NPI Number Information
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NPI Number | 1558642363
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Entity Type | Organization
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Legal Business Name | CASE MANAGEMENT SERVICES OF GEORGIA LLC
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Dates
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Enumeration Date | 09/07/2011
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Last Update Date | 09/07/2011
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Provider Practice Location Address
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Address Line | 425 W OGLETHORPE HWY
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City | HINESVILLE
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State | GA
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Zip | 31313-3621
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Country | US
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Telephone | 912-368-3475
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Fax | 912-368-3420
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Provider Business Mailing Address
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Address Line | 425 W OGLETHORPE HWY
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City | HINESVILLE
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State | GA
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Zip | 31313-3621
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Country | US
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Telephone | 912-368-3475
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Fax | 912-368-3420
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Authorized Official
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Title or Position | PRESIDENT
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Name | DELISA ESPADA
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Credential |
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Telephone | 912-368-3475
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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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