Provider Demographics
NPI:1609110543
Name:CASEY BALL SUPPORTS COORDINATION LLC
Entity Type:Organization
Organization Name:CASEY BALL SUPPORTS COORDINATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:CASEY
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:BALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-884-6965
Mailing Address - Street 1:440 ISABELLA AVE
Mailing Address - Street 2:
Mailing Address - City:CHARLEROI
Mailing Address - State:PA
Mailing Address - Zip Code:15022-2335
Mailing Address - Country:US
Mailing Address - Phone:724-884-6965
Mailing Address - Fax:
Practice Address - Street 1:440 ISABELLA AVE
Practice Address - Street 2:
Practice Address - City:CHARLEROI
Practice Address - State:PA
Practice Address - Zip Code:15022-2335
Practice Address - Country:US
Practice Address - Phone:724-884-6965
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-15
Last Update Date:2012-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management