Provider Demographics
NPI:1235297789
Name:CLINICARE CORPORATION
Entity Type:Organization
Organization Name:CLINICARE CORPORATION
Other - Org Name:EAU CLAIRE ACADEMY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:
Authorized Official - Last Name:ALBRENT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:715-834-6681
Mailing Address - Street 1:550 N DEWEY ST
Mailing Address - Street 2:PO BOX 1168
Mailing Address - City:EAU CLAIRE
Mailing Address - State:WI
Mailing Address - Zip Code:54703-3218
Mailing Address - Country:US
Mailing Address - Phone:715-834-6681
Mailing Address - Fax:715-834-9954
Practice Address - Street 1:550 N DEWEY ST
Practice Address - Street 2:
Practice Address - City:EAU CLAIRE
Practice Address - State:WI
Practice Address - Zip Code:54703-3218
Practice Address - Country:US
Practice Address - Phone:715-834-6681
Practice Address - Fax:715-834-9954
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI322D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children