Provider Demographics
NPI:1548411382
Name:CASE MANAGEMENT OF SOUTHEASTERN KY
Entity Type:Organization
Organization Name:CASE MANAGEMENT OF SOUTHEASTERN KY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:J
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:606-877-4434
Mailing Address - Street 1:1654 HIGHWAY 192 E
Mailing Address - Street 2:
Mailing Address - City:LONDON
Mailing Address - State:KY
Mailing Address - Zip Code:40741-3114
Mailing Address - Country:US
Mailing Address - Phone:606-877-4434
Mailing Address - Fax:606-877-4386
Practice Address - Street 1:15246 S HIGHWAY 421
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:KY
Practice Address - Zip Code:40962-5842
Practice Address - Country:US
Practice Address - Phone:606-598-4218
Practice Address - Fax:606-877-4386
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CAROL DEVELOPMENT COMPANY, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-10-09
Last Update Date:2008-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No251J00000XAgenciesNursing Care
No251X00000XAgenciesSupports Brokerage
No253J00000XAgenciesFoster Care Agency
No253Z00000XAgenciesIn Home Supportive Care