Provider Demographics
NPI:1003009788
Name:CENTRAL CARE SERVICES, INC.
Entity Type:Organization
Organization Name:CENTRAL CARE SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BIRGY
Authorized Official - Middle Name:
Authorized Official - Last Name:BONNEGUE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-337-4338
Mailing Address - Street 1:2001 PALM BEACH LAKES BLVD STE 300D
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33409-6515
Mailing Address - Country:US
Mailing Address - Phone:561-337-4338
Mailing Address - Fax:561-337-9025
Practice Address - Street 1:2001 PALM BEACH LAKES BLVD STE 300D
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33409-6515
Practice Address - Country:US
Practice Address - Phone:561-337-4338
Practice Address - Fax:561-337-9025
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-24
Last Update Date:2018-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
163W00000X, 164W00000X, 235Z00000X, 251J00000X, 253Z00000X, 372500000X, 372600000X, 3747A0650X, 374U00000X, 376J00000X, 376K00000X
FL229958251C00000X, 251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251J00000XAgenciesNursing Care
No163W00000XNursing Service ProvidersRegistered NurseGroup - Multi-Specialty
No164W00000XNursing Service ProvidersLicensed Practical NurseGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Multi-Specialty
No253Z00000XAgenciesIn Home Supportive CareGroup - Multi-Specialty
No372500000XNursing Service Related ProvidersChore ProviderGroup - Multi-Specialty
No372600000XNursing Service Related ProvidersAdult CompanionGroup - Multi-Specialty
No3747A0650XNursing Service Related ProvidersTechnicianAttendant Care ProviderGroup - Multi-Specialty
No374U00000XNursing Service Related ProvidersHome Health AideGroup - Multi-Specialty
No376J00000XNursing Service Related ProvidersHomemakerGroup - Multi-Specialty
No376K00000XNursing Service Related ProvidersNurse's AideGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL023105000Medicaid
FL692710696OtherMED-WAVIER MEDICAID