Provider Demographics
NPI:1104313592
Name:100 CARE COORDINATIONS LLC
Entity type:Organization
Organization Name:100 CARE COORDINATIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:AUGUSTINE
Authorized Official - Middle Name:
Authorized Official - Last Name:IHEDIRIONYE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:267-419-7652
Mailing Address - Street 1:982 GREENBRIAR DR
Mailing Address - Street 2:
Mailing Address - City:BLUE BELL
Mailing Address - State:PA
Mailing Address - Zip Code:19422-3434
Mailing Address - Country:US
Mailing Address - Phone:267-419-7652
Mailing Address - Fax:
Practice Address - Street 1:982 GREENBRIAR DR
Practice Address - Street 2:
Practice Address - City:BLUE BELL
Practice Address - State:PA
Practice Address - Zip Code:19422-3434
Practice Address - Country:US
Practice Address - Phone:267-419-7652
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-20
Last Update Date:2018-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management