Provider Demographics
NPI:1326699927
Name:CARON MARC LLC
Entity Type:Organization
Organization Name:CARON MARC LLC
Other - Org Name:ENCORE OUTPATIENT SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:
Authorized Official - Last Name:BIERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-773-0500
Mailing Address - Street 1:1005 N GLEBE RD STE 300
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22201-5792
Mailing Address - Country:US
Mailing Address - Phone:703-810-7219
Mailing Address - Fax:
Practice Address - Street 1:1005 N GLEBE RD STE 300
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22201-5792
Practice Address - Country:US
Practice Address - Phone:703-665-0646
Practice Address - Fax:703-436-8350
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-25
Last Update Date:2024-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility