MEDICARE: CAROLINE CHEEVERS

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	251B00000X	Case Management Agency
2	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1962785394
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CAROLINE CHEEVERS

Provider Business Mailing Address
First Line	:	13609 STARWREATH DR
Second Line	:
City	:	PEARLAND
State	:	TX
Zip	:	77584-3784
Country	:	US
Telephone Number	:	832-285-2995
Fax Number	:	832-645-3323

Provider Business Practice Location Address
First Line	:	13609 STARWREATH DR
Second Line	:
City	:	PEARLAND
State	:	TX
Zip	:	77584-3784
Country	:	US
Telephone Number	:	832-285-2995
Fax Number	:	832-645-3323

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/21/2011
Last Update Date	:	03/02/2023

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Directions to “ CAROLINE CHEEVERS ” Practice Location

Language	Start Address	Practice Location

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