Provider Demographics
NPI:1336647080
Name:ER WISECARE HEALTH & CASE MANAGEMENT SERVICES LLC
Entity Type:Organization
Organization Name:ER WISECARE HEALTH & CASE MANAGEMENT SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:ESOHE
Authorized Official - Middle Name:
Authorized Official - Last Name:OSAGHAE
Authorized Official - Suffix:
Authorized Official - Credentials:MSN, RN-BC, CCM
Authorized Official - Phone:877-875-4370
Mailing Address - Street 1:185 POINTER RIDGE TRL
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30214-7405
Mailing Address - Country:US
Mailing Address - Phone:877-875-4370
Mailing Address - Fax:
Practice Address - Street 1:185 POINTER RIDGE TRL
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30214-7405
Practice Address - Country:US
Practice Address - Phone:877-875-4370
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-29
Last Update Date:2018-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management