Healthcare Provider Details

I. General information

NPI: 1972210052
Provider Name (Legal Business Name): CAREJENTERPRISE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/31/2022
Last Update Date: 10/31/2022
Certification Date: 09/28/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13531 RYE ST APT 1
SHERMAN OAKS CA
91423-3140
US

IV. Provider business mailing address

13531 RYE ST APT 1
SHERMAN OAKS CA
91423-3140
US

V. Phone/Fax

Practice location:
  • Phone: 661-361-8373
  • Fax:
Mailing address:
  • Phone: 661-361-8373
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: TREMAINE JONES
Title or Position: CEO
Credential: OWNER
Phone: 661-361-8373