Healthcare Provider Details

I. General information

NPI: 1306213541
Provider Name (Legal Business Name): CARE COUNSELING SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/24/2015
Last Update Date: 08/24/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

793-2 JUNIPER RD
VALPARAISO IN
46385-9744
US

IV. Provider business mailing address

793-2 JUNIPER RD
VALPARAISO IN
46385-9744
US

V. Phone/Fax

Practice location:
  • Phone: 219-203-2343
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State

VIII. Authorized Official

Name: JAMES A BERNARD
Title or Position: OWNER
Credential:
Phone: 219-203-2343