Provider Demographics
NPI:1043225907
Name:I AM UNIQUE SPECIAL CARE & CASE MANAGEMENT, INC.
Entity Type:Organization
Organization Name:I AM UNIQUE SPECIAL CARE & CASE MANAGEMENT, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY/CONTOLLER
Authorized Official - Prefix:MR
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:A
Authorized Official - Last Name:CAMPBELL
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:919-981-0135
Mailing Address - Street 1:5800 MCHINES PL
Mailing Address - Street 2:STE 120
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27616
Mailing Address - Country:US
Mailing Address - Phone:919-981-0790
Mailing Address - Fax:919-981-0135
Practice Address - Street 1:5800 MCHINES PL
Practice Address - Street 2:STE 120
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27616
Practice Address - Country:US
Practice Address - Phone:919-981-0790
Practice Address - Fax:919-981-0135
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-29
Last Update Date:2016-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA258825251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7100137Medicaid
NC3408581Medicaid
NC0071YOtherBCBS PROVIDER NUMBER