Provider Demographics
NPI:1912718008
Name:Y W B CASE MANAGEMENT LLC
Entity type:Organization
Organization Name:Y W B CASE MANAGEMENT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:YVONNE
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIS-BENDOLPH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-944-1189
Mailing Address - Street 1:PO BOX 148
Mailing Address - Street 2:
Mailing Address - City:DACULA
Mailing Address - State:GA
Mailing Address - Zip Code:30019-0003
Mailing Address - Country:US
Mailing Address - Phone:404-944-1189
Mailing Address - Fax:
Practice Address - Street 1:2968 STOCKBRIDGE WAY
Practice Address - Street 2:
Practice Address - City:DACULA
Practice Address - State:GA
Practice Address - Zip Code:30019-6867
Practice Address - Country:US
Practice Address - Phone:404-944-1189
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-16
Last Update Date:2025-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Single Specialty