Provider Demographics
NPI:1114372661
Name:KATHY MICHAEL INDEPENDENT CASE MANAGEMENT LLC
Entity Type:Organization
Organization Name:KATHY MICHAEL INDEPENDENT CASE MANAGEMENT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CASE MANAGEMENT
Authorized Official - Prefix:MISS
Authorized Official - First Name:KATHIE
Authorized Official - Middle Name:
Authorized Official - Last Name:MICHAEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:620-377-7075
Mailing Address - Street 1:3420 BROADWAY AVE
Mailing Address - Street 2:
Mailing Address - City:GREAT BEND
Mailing Address - State:KS
Mailing Address - Zip Code:67530-3624
Mailing Address - Country:US
Mailing Address - Phone:620-377-7075
Mailing Address - Fax:
Practice Address - Street 1:3420 BROADWAY AVE
Practice Address - Street 2:
Practice Address - City:GREAT BEND
Practice Address - State:KS
Practice Address - Zip Code:67530-3624
Practice Address - Country:US
Practice Address - Phone:620-377-7075
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-03
Last Update Date:2016-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management