Custom Care Case Management Inc

Primary specialty

Case Management AgencyTaxonomy code 251B00000X

Legal business name

CUSTOM CARE CASE MANAGEMENT INC

Practice address

4800 Sugar Grove Blvd Ste 308
Stafford, TX 77477-2639

Phone

(281) 818-4780

Fax

(281) 408-4169

NPI assigned

Sep 7, 2023

Last updated

Sep 7, 2023By 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

Ms. Eva Chanel HarrisNPI 1114276946

Title

Chief Executive Officer

Phone

(281) 818-4780

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Eva C Harris

  • Case Manager/Care Coordinator
  • Stafford, TX
  • NPI 1114276946
  NPD Authorized official

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

{
    "created_epoch": "1694044800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694044800000",
    "number": "1801672449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2011 KNOLL OAK LN",
            "city": "ROSENBERG",
            "state": "TX",
            "postal_code": "774695732",
            "telephone_number": "281-818-4780",
            "fax_number": "281-408-4169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4800 SUGAR GROVE BLVD STE 308",
            "city": "STAFFORD",
            "state": "TX",
            "postal_code": "774772639",
            "telephone_number": "281-818-4780",
            "fax_number": "281-408-4169"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CUSTOM CARE CASE MANAGEMENT INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-07",
        "last_updated": "2023-09-07",
        "certification_date": "2023-09-07",
        "status": "A",
        "authorized_official_last_name": "HARRIS",
        "authorized_official_first_name": "EVA",
        "authorized_official_middle_name": "CHANEL",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "281-818-4780",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Case Management Agency in Stafford, TX
• Providers in Stafford, TX by specialty
• Case Management Agency in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2023; 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.