Organization
CARITAS CRITICAL CASE MANAGEMENT, LLC
Active
Organization
CARITAS CRITICAL CASE MANAGEMENT, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EBONY BLACKMOM-HUMPHREY RN, CCM (REGISTERED NURSE)
(206) 207-9363
Entity
Organization
Contact information
Practice address
23205 SE BLACK NUGGET RD, APT J2, ISSAQUAH, WA 98029-7326
(206) 207-9363
Mailing address
23205 SE BLACK NUGGET RD, APT J2, ISSAQUAH, WA 98029-7326
(206) 207-9363
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN60625891
WA
163WC0400X
Case Management Registered Nurse
Primary
4219311
NJ
163WP0808X
Psychiatric/Mental Health Registered Nurse
RN60625891
WA
Other
Enumeration date
04/24/2017
Last updated
04/24/2017
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up