MEDICARE: CARE AND EMPOWERMENT SERVICES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1194092924
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CARE AND EMPOWERMENT SERVICES

Provider Business Mailing Address
First Line	:	4108 FALCONRIDGE RD
Second Line	:
City	:	GREENSBORO
State	:	NC
Zip	:	27405-5414
Country	:	US
Telephone Number	:	336-907-5003
Fax Number	:

Provider Business Practice Location Address
First Line	:	1025 HOMELAND AVE
Second Line	:	SUITE 6
City	:	GREENSBORO
State	:	NC
Zip	:	27405-7003
Country	:	US
Telephone Number	:	336-907-5003
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	MS. ALYCIA LEDWELL SHAW
Credential	:	MSQP
Telephone Number	:	336-907-5003

Provider Enumeration Date	:	11/22/2011
Last Update Date	:	11/22/2011

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