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General NPI Number Information
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NPI Number | 1871973933
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Entity Type | Organization
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Legal Business Name | CARE COMMUNITY
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Dates
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Enumeration Date | 06/04/2015
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Last Update Date | 06/04/2015
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Provider Practice Location Address
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Address Line | 565 GENERAL AVE
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City | SPRINGFIELD
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State | MI
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Zip | 49037-7553
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Country | US
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Telephone | 269-968-3365
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Fax |
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Provider Business Mailing Address
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Address Line | 565 GENERAL AVE
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City | SPRINGFIELD
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State | MI
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Zip | 49037-7553
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | BRIAN CAREY
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Credential |
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Telephone | 269-968-3365
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 385H00000X
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Taxonomy Name | Respite Care
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License Number | AH130254965
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License Number State | MI
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