Provider Demographics
NPI:1083757124
Name:CASE MANAGEMENT UNIT
Entity Type:Organization
Organization Name:CASE MANAGEMENT UNIT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:VERANO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-232-8761
Mailing Address - Street 1:1100 S CAMERON ST
Mailing Address - Street 2:BLENDED CASE MANAGEMENT
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17104-2547
Mailing Address - Country:US
Mailing Address - Phone:717-232-8761
Mailing Address - Fax:
Practice Address - Street 1:1100 S CAMERON ST
Practice Address - Street 2:BLENDED CASE MANAGEMENT
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17104-2547
Practice Address - Country:US
Practice Address - Phone:717-232-8761
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-15
Last Update Date:2014-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1000024470011Medicaid
PA1000024470015Medicaid