Provider Demographics
NPI:1407270168
Name:SUSIE DECKER CASE MANAGEMENT SERVICES LLC
Entity Type:Organization
Organization Name:SUSIE DECKER CASE MANAGEMENT SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CASE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:R
Authorized Official - Last Name:BECKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:620-203-0344
Mailing Address - Street 1:1208 LYNX RD SW
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:KS
Mailing Address - Zip Code:66839-9249
Mailing Address - Country:US
Mailing Address - Phone:620-203-0344
Mailing Address - Fax:785-260-9047
Practice Address - Street 1:1208 LYNX RD SW
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:KS
Practice Address - Zip Code:66839-9249
Practice Address - Country:US
Practice Address - Phone:620-203-0344
Practice Address - Fax:785-260-9047
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-14
Last Update Date:2014-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management