Provider Demographics
NPI:1528480514
Name:CASE MANAGEMENT SOLUTIONS
Entity type:Organization
Organization Name:CASE MANAGEMENT SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CASE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:BONNIE
Authorized Official - Middle Name:FAYE
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:LBSW
Authorized Official - Phone:512-560-5896
Mailing Address - Street 1:403 SKYLINE RD
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:TX
Mailing Address - Zip Code:78628-3826
Mailing Address - Country:US
Mailing Address - Phone:512-560-5896
Mailing Address - Fax:
Practice Address - Street 1:403 SKYLINE RD
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:TX
Practice Address - Zip Code:78628-3826
Practice Address - Country:US
Practice Address - Phone:512-560-5896
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-10
Last Update Date:2014-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1992903033Medicaid
TX1194883132Medicaid