Provider Demographics
NPI:1336235795
Name:EASTERN CAROLINA CASE MANAGEMENT
Entity Type:Organization
Organization Name:EASTERN CAROLINA CASE MANAGEMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DIRECTOR OF OPERATIONS
Authorized Official - Prefix:MRS
Authorized Official - First Name:LESLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:DOVER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-531-2902
Mailing Address - Street 1:564 VERNON WHITE RD
Mailing Address - Street 2:
Mailing Address - City:WINTERVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28590-8672
Mailing Address - Country:US
Mailing Address - Phone:252-531-2902
Mailing Address - Fax:
Practice Address - Street 1:154 BEACON DR
Practice Address - Street 2:SUITE I
Practice Address - City:WINTERVILLE
Practice Address - State:NC
Practice Address - Zip Code:28590-7860
Practice Address - Country:US
Practice Address - Phone:252-353-1114
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-05
Last Update Date:2009-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3418417Medicaid
NC8302218Medicaid
NC8300344GMedicaid
NC8300344BMedicaid
NC5904295Medicaid
NC8300344HMedicaid
NC8300344Medicaid
NC6006047Medicaid
NC8302218KMedicaid