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General NPI Number Information
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NPI Number | 1700243979
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Entity Type | Organization
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Legal Business Name | COMPASSIONATE CARE CASE MANAGEMENT SERVICES, LLC
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Dates
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Enumeration Date | 01/19/2016
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Last Update Date | 01/19/2016
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Provider Practice Location Address
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Address Line | 4 HIDDEN SANDS CT
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City | COLUMBIA
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State | SC
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Zip | 29229-7615
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Country | US
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Telephone | 803-514-3483
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Fax |
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Provider Business Mailing Address
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Address Line | 4 HIDDEN SANDS CT
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City | COLUMBIA
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State | SC
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Zip | 29229-7615
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Country | US
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Telephone | 803-514-3483
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. DEBORAH YOUNG
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Credential | M.ED, M.A.
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Telephone | 803-514-3483
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 305S00000X
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Taxonomy Name | Point of Service
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License Number |
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License Number State |
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