Provider Demographics
NPI:1467157834
Name:CARIBBEAN HOME CARE GROUP LLC
Entity Type:Organization
Organization Name:CARIBBEAN HOME CARE GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:COPELAND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:408-819-1915
Mailing Address - Street 1:10127 CLAPTON LN
Mailing Address - Street 2:
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95212-9361
Mailing Address - Country:US
Mailing Address - Phone:209-659-4110
Mailing Address - Fax:
Practice Address - Street 1:10127 CLAPTON LN
Practice Address - Street 2:
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95212-9361
Practice Address - Country:US
Practice Address - Phone:209-659-4110
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-04
Last Update Date:2023-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care