Provider Demographics
NPI:1477042620
Name:CDS CARE & SUPPORT
Entity Type:Organization
Organization Name:CDS CARE & SUPPORT
Other - Org Name:SENIOR HELPERS FORT MYERS & CAPE CORAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:MANUEL
Authorized Official - Middle Name:
Authorized Official - Last Name:CHAVEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:239-931-0262
Mailing Address - Street 1:2726 OAK RIDGE CT STE 502
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33901-9356
Mailing Address - Country:US
Mailing Address - Phone:239-931-0158
Mailing Address - Fax:850-757-0070
Practice Address - Street 1:2726 OAK RIDGE CT STE 502
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33901-9356
Practice Address - Country:US
Practice Address - Phone:239-931-0158
Practice Address - Fax:850-757-0070
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-03
Last Update Date:2018-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL299994703251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health