Provider Demographics
NPI:1942352406
Name:B&C CASE MANAGEMENT
Entity Type:Organization
Organization Name:B&C CASE MANAGEMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SERVICE COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:SALLY
Authorized Official - Middle Name:C
Authorized Official - Last Name:COLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:1208-566-7788
Mailing Address - Street 1:PO BOX 739
Mailing Address - Street 2:105 S. RAILROAD
Mailing Address - City:COUNCIL
Mailing Address - State:ID
Mailing Address - Zip Code:83612-0739
Mailing Address - Country:US
Mailing Address - Phone:120-856-6778
Mailing Address - Fax:120-835-2477
Practice Address - Street 1:105 S. RAILROAD
Practice Address - Street 2:
Practice Address - City:COUNCIL
Practice Address - State:ID
Practice Address - Zip Code:83612-0739
Practice Address - Country:US
Practice Address - Phone:120-856-6778
Practice Address - Fax:120-835-2477
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID8072839Medicaid
ID8072840Medicaid
ID8074422Medicaid