Provider Demographics
NPI:1518105188
Name:CARE CONNECTORS
Entity Type:Organization
Organization Name:CARE CONNECTORS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:JODI
Authorized Official - Middle Name:
Authorized Official - Last Name:ENGAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-425-3243
Mailing Address - Street 1:PO BOX 230696
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89123
Mailing Address - Country:US
Mailing Address - Phone:702-425-3243
Mailing Address - Fax:702-430-1681
Practice Address - Street 1:4952 DANUBE AVE
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89141-3837
Practice Address - Country:US
Practice Address - Phone:702-425-3243
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-04
Last Update Date:2009-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV1008049573251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health