Provider Demographics
NPI:1366069254
Name:ELITE CASE MANAGEMENT SOLUTIONS LLC
Entity type:Organization
Organization Name:ELITE CASE MANAGEMENT SOLUTIONS LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:YAKIYAH
Authorized Official - Middle Name:LATRICE
Authorized Official - Last Name:BLACKWELL
Authorized Official - Suffix:
Authorized Official - Credentials:MS,BA
Authorized Official - Phone:803-316-1443
Mailing Address - Street 1:2899 GIRARD DR
Mailing Address - Street 2:
Mailing Address - City:SUMTER
Mailing Address - State:SC
Mailing Address - Zip Code:29150-1866
Mailing Address - Country:US
Mailing Address - Phone:803-316-1443
Mailing Address - Fax:
Practice Address - Street 1:528 BROAD ST STE 201
Practice Address - Street 2:
Practice Address - City:SUMTER
Practice Address - State:SC
Practice Address - Zip Code:29150-3368
Practice Address - Country:US
Practice Address - Phone:803-316-1443
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-26
Last Update Date:2020-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management