Provider Demographics
NPI:1528408267
Name:INDEPENDENT CASE MANAGEMENT
Entity Type:Organization
Organization Name:INDEPENDENT CASE MANAGEMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CINDY
Authorized Official - Middle Name:
Authorized Official - Last Name:ALBERDING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:501-268-0063
Mailing Address - Street 1:13310 KANIS RD
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72211-4008
Mailing Address - Country:US
Mailing Address - Phone:501-268-0063
Mailing Address - Fax:501-268-0070
Practice Address - Street 1:13310 KANIS RD
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72211-4008
Practice Address - Country:US
Practice Address - Phone:501-268-0063
Practice Address - Fax:501-268-0070
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-26
Last Update Date:2013-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR196903706Medicaid