Healthcare Provider Details

I. General information

NPI: 1306317268
Provider Name (Legal Business Name): CARE BEARS SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/17/2018
Last Update Date: 12/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1280 LANTANA RD
LANTANA FL
33462-1543
US

IV. Provider business mailing address

5901 LINCOLN CIR W
LAKE WORTH FL
33463-6744
US

V. Phone/Fax

Practice location:
  • Phone: 954-548-9124
  • Fax:
Mailing address:
  • Phone: 954-548-9124
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MARIE CHANTAL RICLAIR
Title or Position: ADMINISTRATOR
Credential:
Phone: 954-548-9124