MEDICARE: RESOURCE TARGETED CASE MANAGEMENT AGENCY INC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251B00000X	Case Management Agency

General Provider Information

NPI Number	:	1568750396
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RESOURCE TARGETED CASE MANAGEMENT AGENCY INC

Provider Business Mailing Address
First Line	:	3127 W HALLANDALE BEACH BLVD
Second Line	:	SUITE 115
City	:	HALLANDALE
State	:	FL
Zip	:	33009-5150
Country	:	US
Telephone Number	:	954-534-5773
Fax Number	:

Provider Business Practice Location Address
First Line	:	3127 W HALLANDALE BEACH BLVD
Second Line	:	SUITE 115
City	:	HALLANDALE
State	:	FL
Zip	:	33009-5150
Country	:	US
Telephone Number	:	954-534-5773
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MRS. BARBARA LUKE
Credential	:
Telephone Number	:	954-534-5773

Provider Enumeration Date	:	07/13/2011
Last Update Date	:	07/13/2011

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