Provider Demographics
NPI:1306152020
Name:SOUTHEASTERN MEDICAL CASE MANAGEMENT & REHAB SERVICES, INC
Entity type:Organization
Organization Name:SOUTHEASTERN MEDICAL CASE MANAGEMENT & REHAB SERVICES, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:JONATHAN
Authorized Official - Last Name:EATON
Authorized Official - Suffix:SR
Authorized Official - Credentials:RN, CCM, CNLCP
Authorized Official - Phone:8285-505-7550
Mailing Address - Street 1:1 TOWN SQUARE BLVD
Mailing Address - Street 2:SUITE 263
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28803-5006
Mailing Address - Country:US
Mailing Address - Phone:828-505-7550
Mailing Address - Fax:828-505-2380
Practice Address - Street 1:1 TOWN SQUARE BLVD
Practice Address - Street 2:SUITE 263
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28803-5006
Practice Address - Country:US
Practice Address - Phone:828-505-7550
Practice Address - Fax:828-505-2380
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-19
Last Update Date:2010-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC151506251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management