Healthcare Provider Details

I. General information

NPI: 1871973933
Provider Name (Legal Business Name): CARE COMMUNITY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/04/2015
Last Update Date: 06/04/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

565 GENERAL AVE
SPRINGFIELD MI
49037-7553
US

IV. Provider business mailing address

565 GENERAL AVE
SPRINGFIELD MI
49037-7553
US

V. Phone/Fax

Practice location:
  • Phone: 269-968-3365
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code385H00000X
TaxonomyRespite Care
License NumberAH130254965
License Number StateMI

VIII. Authorized Official

Name: BRIAN CAREY
Title or Position: PRESIDENT
Credential:
Phone: 269-968-3365