Provider Demographics
NPI:1083989008
Name:CORPORATE CARE INTERNATIONAL, INC.
Entity Type:Organization
Organization Name:CORPORATE CARE INTERNATIONAL, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:HELENE
Authorized Official - Middle Name:
Authorized Official - Last Name:MESTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-702-0876
Mailing Address - Street 1:PO BOX 741901
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33474-1901
Mailing Address - Country:US
Mailing Address - Phone:561-702-0876
Mailing Address - Fax:
Practice Address - Street 1:5317 BROOKLAWN TER
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33437-1659
Practice Address - Country:US
Practice Address - Phone:561-702-0876
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-09
Last Update Date:2012-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW31951041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLZ5347Medicare UPIN