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NPI Code Detail

MEDICARE: CARITAS HEALTH CARE SERVICES LLC

MEDICARE: CARITAS HEALTH CARE SERVICES LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1320900000XIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility

General Provider Information

NPI Number : 1629799077
Entity Type Code : Organization
Provider Name (Legal Business Name) : CARITAS HEALTH CARE SERVICES LLC
Provider Business Mailing Address
First Line : 23518 BAKER HILL DR
Second Line :
City : RICHMOND
State : TX
Zip : 77469-2568
Country : US
Telephone Number : 508-371-8503
Fax Number :
Provider Business Practice Location Address
First Line : 23518 BAKER HILL DR
Second Line :
City : RICHMOND
State : TX
Zip : 77469-2568
Country : US
Telephone Number : 508-371-8503
Fax Number :
Authorized Official
Title or Position : PROGRAM MANAGER
Name : ROSETTE N WAKANABO
Credential :
Telephone Number : 508-371-8503
Provider Enumeration Date : 09/05/2022
Last Update Date : 09/05/2022

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Directions to “CARITAS HEALTH CARE SERVICES LLC ” Practice Location

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