Provider Demographics
NPI:1477946671
Name:ICARE MANAGEMENT SERVICES INC
Entity Type:Organization
Organization Name:ICARE MANAGEMENT SERVICES INC
Other - Org Name:ICARE MANAGEMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PRAXEDES
Authorized Official - Middle Name:B
Authorized Official - Last Name:DEMESA
Authorized Official - Suffix:
Authorized Official - Credentials:MPA, NHA, BSMT
Authorized Official - Phone:209-406-6610
Mailing Address - Street 1:1111 W ROBINHOOD DR
Mailing Address - Street 2:
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95207-5626
Mailing Address - Country:US
Mailing Address - Phone:209-406-6610
Mailing Address - Fax:209-451-4997
Practice Address - Street 1:1111 W ROBINHOOD DR
Practice Address - Street 2:
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95207-5626
Practice Address - Country:US
Practice Address - Phone:209-406-6610
Practice Address - Fax:209-451-4997
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-12
Last Update Date:2015-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251X00000XAgenciesSupports Brokerage