MEDICARE: QUALITY CARE CASE MANAGEMENT, LLC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	235500000X	Speech/Language/Hearing Specialist/Technologist
2	235Z00000X	Speech-Language Pathologist
3	225100000X	Physical Therapist
4	225X00000X	Occupational Therapist
5	251S00000X	Community/Behavioral Health Agency
6	251B00000X	Case Management Agency

General Provider Information

NPI Number	:	1346582343
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	QUALITY CARE CASE MANAGEMENT, LLC.

Provider Business Mailing Address
First Line	:	1746 POOSEY RIDGE RD
Second Line	:
City	:	RICHMOND
State	:	KY
Zip	:	40475-9774
Country	:	US
Telephone Number	:	859-972-0811
Fax Number	:	859-972-0811

Provider Business Practice Location Address
First Line	:	1746 POOSEY RIDGE RD
Second Line	:
City	:	RICHMOND
State	:	KY
Zip	:	40475-9774
Country	:	US
Telephone Number	:	859-625-8586
Fax Number	:	859-972-0811

Authorized Official
Title or Position	:	OWNER/EXECUTIVE DIRECTOR
Name	:	MRS. TERRA DURBIN
Credential	:	MHA, QMRP, SCL MRP
Telephone Number	:	859-625-8586

Provider Enumeration Date	:	03/18/2013
Last Update Date	:	05/09/2018

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Directions to “QUALITY CARE CASE MANAGEMENT, LLC. ” Practice Location

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