Organization
INDEPENDENT CASE MANAGEMENT, INC.
Active
Other names
ICM
Organization subpart
No
Provider details
NPI number
Authorized official
JOSH WILSON PH.D. (CEO)
(501) 228-0063
Entity
Organization
Contact information
Practice address
1525 MERRILL DRIVE, LITTLE ROCK, AR 72211-1821
(501) 228-0063
(501) 228-0070
Mailing address
1525 MERRILL DRIVE, LITTLE ROCK, AR 72211-1821
(501) 228-0063
(501) 228-0070
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
125831774
—
AR
05
—
129558732
—
AR
05
—
129701767
—
AR
05
—
130082782
—
AR
01
—
132608786
DDS
AR
05
—
134456775
—
AR
05
—
193204724
—
AR
05
—
196924706
—
AR
Enumeration date
02/20/2007
Last updated
05/07/2021
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