Leslie Ann Bacastow
Individual provider Active NPI Case Manager/Care Coordinator · Comer, GA
NPI 1104280197 · NPPES record last updated Apr 6, 2016
Key facts
- NPI
- 1104280197
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Case Manager/Care Coordinator 171M00000X
- Practice address
- 28 Brad Graham Rd
Comer, GA 30629-6200 - Phone
- (706) 540-7348
- NPI assigned
- Apr 6, 2016
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | Yes |
Addresses
Primary practice location
28 Brad Graham Rd
Comer, GA 30629-6200
Mailing address
28 Brad Graham Rd
Comer, GA 30629-6200
Phone (706) 540-7348
Other providers in Comer, GA
All providers in Comer, GA · Case Manager/Care Coordinator in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 6, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.