Provider Demographics
NPI:1942501804
Name:CARDINAL CASE MANAGEMENT, LLC
Entity Type:Organization
Organization Name:CARDINAL CASE MANAGEMENT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KELLY
Authorized Official - Middle Name:MCKINNEY
Authorized Official - Last Name:BARNETT
Authorized Official - Suffix:
Authorized Official - Credentials:BS, QP
Authorized Official - Phone:828-765-4668
Mailing Address - Street 1:31 CROSS ST
Mailing Address - Street 2:SUITE 219
Mailing Address - City:SPRUCE PINE
Mailing Address - State:NC
Mailing Address - Zip Code:28777-6158
Mailing Address - Country:US
Mailing Address - Phone:828-765-4668
Mailing Address - Fax:828-765-4669
Practice Address - Street 1:70 WOODFIN PL
Practice Address - Street 2:SUITE 130
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28801-2463
Practice Address - Country:US
Practice Address - Phone:828-253-2351
Practice Address - Fax:828-253-2350
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-09
Last Update Date:2010-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC36351OtherWESTERN HIGHLANDS NETWORK CONTRACT
NC99582OtherSMOKY MOUNTAIN CENTER CONTRACT