Provider Demographics
NPI:1750917811
Name:HURON CASE MANAGEMENT
Entity type:Organization
Organization Name:HURON CASE MANAGEMENT
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SONIA
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAH
Authorized Official - Suffix:
Authorized Official - Credentials:BS BSN CCM
Authorized Official - Phone:855-487-6626
Mailing Address - Street 1:29488 WOODWARD AVE # 163
Mailing Address - Street 2:
Mailing Address - City:ROYAL OAK
Mailing Address - State:MI
Mailing Address - Zip Code:48073-0903
Mailing Address - Country:US
Mailing Address - Phone:855-487-6626
Mailing Address - Fax:734-629-0816
Practice Address - Street 1:830 E FOURTH ST
Practice Address - Street 2:#1
Practice Address - City:ROYAL OAK
Practice Address - State:MI
Practice Address - Zip Code:48067
Practice Address - Country:US
Practice Address - Phone:855-487-6626
Practice Address - Fax:734-629-0816
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-19
Last Update Date:2023-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WC0400XNursing Service ProvidersRegistered NurseCase ManagementGroup - Multi-Specialty
No251B00000XAgenciesCase ManagementGroup - Multi-Specialty