Provider Demographics
NPI:1679992556
Name:ACT CASE MANAGEMENT
Entity Type:Organization
Organization Name:ACT CASE MANAGEMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANITA
Authorized Official - Middle Name:CAROL
Authorized Official - Last Name:TILLMAN
Authorized Official - Suffix:
Authorized Official - Credentials:LBSW
Authorized Official - Phone:210-279-4235
Mailing Address - Street 1:4010 SYLVANOAKS DR
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-4734
Mailing Address - Country:US
Mailing Address - Phone:210-279-4235
Mailing Address - Fax:
Practice Address - Street 1:4010 SYLVANOAKS DR
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-4734
Practice Address - Country:US
Practice Address - Phone:210-279-4235
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-08
Last Update Date:2014-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX38824251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management