Provider Demographics
NPI:1164169744
Name:CARE CHOICE CARE MANAGEMENT
Entity Type:Organization
Organization Name:CARE CHOICE CARE MANAGEMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:VICTORIA
Authorized Official - Middle Name:
Authorized Official - Last Name:SHEPHERD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-315-5148
Mailing Address - Street 1:101 W ARGONNE DR STE 198
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63122-4201
Mailing Address - Country:US
Mailing Address - Phone:636-288-1764
Mailing Address - Fax:
Practice Address - Street 1:3043 APPLE BLOSSOM CT
Practice Address - Street 2:
Practice Address - City:HIGH RIDGE
Practice Address - State:MO
Practice Address - Zip Code:63049
Practice Address - Country:US
Practice Address - Phone:636-288-1764
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-16
Last Update Date:2022-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management