Provider Demographics
NPI:1306898390
Name:CLINICAL MANAGEMENT SERVICES, INC.
Entity type:Organization
Organization Name:CLINICAL MANAGEMENT SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:
Authorized Official - Last Name:VANOVER
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:219-987-3270
Mailing Address - Street 1:610 N HALLECK ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:DEMOTTE
Mailing Address - State:IN
Mailing Address - Zip Code:46310-9545
Mailing Address - Country:US
Mailing Address - Phone:219-987-3270
Mailing Address - Fax:219-987-2270
Practice Address - Street 1:610 N HALLECK ST
Practice Address - Street 2:SUITE A
Practice Address - City:DEMOTTE
Practice Address - State:IN
Practice Address - Zip Code:46310-9545
Practice Address - Country:US
Practice Address - Phone:219-987-3270
Practice Address - Fax:219-987-2270
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN157240Medicare ID - Type UnspecifiedHOME HEALTH CARE PROVIDER