Provider Demographics
NPI:1003666439
Name:CARE COLLECTIVE THERAPY LLC
Entity Type:Organization
Organization Name:CARE COLLECTIVE THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:BRITTANY
Authorized Official - Middle Name:
Authorized Official - Last Name:PURDY ANGEJA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-250-2587
Mailing Address - Street 1:5650 WHITELOCK PARKWAY
Mailing Address - Street 2:STE 130 #2085
Mailing Address - City:ELK GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:95757
Mailing Address - Country:US
Mailing Address - Phone:916-250-2587
Mailing Address - Fax:855-225-3588
Practice Address - Street 1:5650 WHITELOCK PARKWAY
Practice Address - Street 2:STE 130 #2085
Practice Address - City:ELK GROVE
Practice Address - State:CA
Practice Address - Zip Code:95757
Practice Address - Country:US
Practice Address - Phone:916-250-2587
Practice Address - Fax:855-225-3588
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-26
Last Update Date:2024-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty