Organization
ASSUREDLINK CASE MANAGEMENT AGENCY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DEMETRIUS DEPP KING E.D. (OWNER/ EXECUTIVE DIRECTOR)
(270) 303-4669
Entity
Organization
Contact information
Practice address
1990 LOUISVILLE RD, 101, BOWLING GREEN, KY 42101-1202
(270) 599-0212
Mailing address
1990 LOUISVILLE RD, 101, BOWLING GREEN, KY 42101-1202
(270) 599-0212
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
171431
KY
251B00000X
Case Management Agency
7100347620
KY
347C00000X
Private Vehicle
Primary
K12245600
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100224880
—
KY
05
—
7100347620
—
KY
05
—
7100438780
—
KY
Enumeration date
12/10/2013
Last updated
03/03/2017
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