Provider Demographics
NPI:1508456633
Name:CARESPHERE CT LLC
Entity Type:Organization
Organization Name:CARESPHERE CT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:YITA
Authorized Official - Middle Name:
Authorized Official - Last Name:MANDEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:845-641-6113
Mailing Address - Street 1:233 LAFAYETTE AVE STE 103
Mailing Address - Street 2:
Mailing Address - City:SUFFERN
Mailing Address - State:NY
Mailing Address - Zip Code:10901-4821
Mailing Address - Country:US
Mailing Address - Phone:845-641-6113
Mailing Address - Fax:
Practice Address - Street 1:2389 MAIN ST STE 100
Practice Address - Street 2:
Practice Address - City:GLASTONBURY
Practice Address - State:CT
Practice Address - Zip Code:06033-4617
Practice Address - Country:US
Practice Address - Phone:610-868-1801
Practice Address - Fax:610-954-9367
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-22
Last Update Date:2021-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health