Provider Demographics
NPI:1073296331
Name:PARIS HEIGHTS CASE MANAGEMENT AGENCY, LLC
Entity Type:Organization
Organization Name:PARIS HEIGHTS CASE MANAGEMENT AGENCY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TRACY
Authorized Official - Middle Name:
Authorized Official - Last Name:THOMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:476-390-1172
Mailing Address - Street 1:3014 GRAY HWY STE 3
Mailing Address - Street 2:
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31211-6687
Mailing Address - Country:US
Mailing Address - Phone:478-390-1172
Mailing Address - Fax:
Practice Address - Street 1:3014 GRAY HWY STE 3
Practice Address - Street 2:
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31211-6687
Practice Address - Country:US
Practice Address - Phone:478-390-1172
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-11
Last Update Date:2023-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management