Provider Demographics
NPI:1639525702
Name:ALLIANCE CASE MANAGEMENT
Entity Type:Organization
Organization Name:ALLIANCE CASE MANAGEMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHANNON
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:MEEKS
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:307-747-1055
Mailing Address - Street 1:657 PARKWAY DR.
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN VIEW
Mailing Address - State:WY
Mailing Address - Zip Code:82939
Mailing Address - Country:US
Mailing Address - Phone:307-747-1055
Mailing Address - Fax:307-782-8208
Practice Address - Street 1:657 PARKWAY DR.
Practice Address - Street 2:
Practice Address - City:MOUNTAIN VIEW
Practice Address - State:WY
Practice Address - Zip Code:82939
Practice Address - Country:US
Practice Address - Phone:307-747-1055
Practice Address - Fax:307-782-8208
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-09
Last Update Date:2016-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY19520171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Multi-Specialty