Provider Demographics
NPI:1316600570
Name:CENTRIC CARE MANAGEMENT INC
Entity Type:Organization
Organization Name:CENTRIC CARE MANAGEMENT INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:GUGICK
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:602-922-3388
Mailing Address - Street 1:21001 N TATUM BLVD STE 1630-425
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85050-4242
Mailing Address - Country:US
Mailing Address - Phone:602-922-3388
Mailing Address - Fax:602-922-3366
Practice Address - Street 1:5550 E DEER VALLEY DR UNIT 159
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85054-5662
Practice Address - Country:US
Practice Address - Phone:602-922-3388
Practice Address - Fax:602-922-3366
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-14
Last Update Date:2021-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management