Provider Demographics
NPI:1578658282
Name:QUALITY CASE MANAGEMENT, INC.
Entity Type:Organization
Organization Name:QUALITY CASE MANAGEMENT, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:GARY
Authorized Official - Middle Name:T
Authorized Official - Last Name:CORCORAN
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:507-437-9085
Mailing Address - Street 1:203 10TH AVE NW
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:MN
Mailing Address - Zip Code:55912-2909
Mailing Address - Country:US
Mailing Address - Phone:507-437-9085
Mailing Address - Fax:507-437-2393
Practice Address - Street 1:203 10TH AVE NW
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:MN
Practice Address - Zip Code:55912-2909
Practice Address - Country:US
Practice Address - Phone:507-437-9085
Practice Address - Fax:507-437-2393
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-04
Last Update Date:2008-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN385734400Medicaid