Source Care Management LLC

Primary specialty

Case Management AgencyTaxonomy code 251B00000X

Legal business name

SOURCE CARE MANAGEMENT LLC

Practice address

316 Merritt St
Hawkinsville, GA 31036-1733

Phone

(478) 621-2070

Fax

(866) 773-8473

NPI assigned

Jan 11, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Claudette Slade, CPA

Title

Vice President of Finance

Phone

(478) 621-2070

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1168473600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1083764138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "316 MERRITT ST",
            "address_2": "P. O. BOX 952",
            "city": "HAWKINSVILLE",
            "state": "GA",
            "postal_code": "310361733",
            "telephone_number": "478-621-2070",
            "fax_number": "866-773-8473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "316 MERRITT ST",
            "city": "HAWKINSVILLE",
            "state": "GA",
            "postal_code": "310361733",
            "telephone_number": "478-621-2070",
            "fax_number": "866-773-8473"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOURCE CARE MANAGEMENT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-11",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SLADE",
        "authorized_official_first_name": "CLAUDETTE",
        "authorized_official_title_or_position": "VICE PRESIDENT OF FINANCE",
        "authorized_official_telephone_number": "478-621-2070",
        "authorized_official_credential": "CPA"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "GA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Case Management Agency in Hawkinsville, GA
• Providers in Hawkinsville, GA by specialty
• Case Management Agency in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.