Provider Demographics
NPI:1144409186
Name:C.I.V.I.L CARE & CASE MANAGEMENT, INC.
Entity Type:Organization
Organization Name:C.I.V.I.L CARE & CASE MANAGEMENT, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:GREEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-670-3670
Mailing Address - Street 1:604 REGGIE CT
Mailing Address - Street 2:
Mailing Address - City:SPRING LAKE
Mailing Address - State:NC
Mailing Address - Zip Code:28390-3024
Mailing Address - Country:US
Mailing Address - Phone:910-670-3670
Mailing Address - Fax:
Practice Address - Street 1:604 REGGIE CT
Practice Address - Street 2:
Practice Address - City:SPRING LAKE
Practice Address - State:NC
Practice Address - Zip Code:28390-3024
Practice Address - Country:US
Practice Address - Phone:910-670-3670
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-26
Last Update Date:2007-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health