Provider Demographics
NPI:1518694389
Name:CAI HEALTH & WELLNESS LLC
Entity Type:Organization
Organization Name:CAI HEALTH & WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NP
Authorized Official - Prefix:
Authorized Official - First Name:CECILIA
Authorized Official - Middle Name:IFEOMA
Authorized Official - Last Name:IBE
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:305-335-7131
Mailing Address - Street 1:2095 CLUB LAKE DR
Mailing Address - Street 2:
Mailing Address - City:ORANGE PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32065-2648
Mailing Address - Country:US
Mailing Address - Phone:305-335-7131
Mailing Address - Fax:
Practice Address - Street 1:2095 CLUB LAKE DR
Practice Address - Street 2:
Practice Address - City:ORANGE PARK
Practice Address - State:FL
Practice Address - Zip Code:32065-2648
Practice Address - Country:US
Practice Address - Phone:305-335-7131
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-02
Last Update Date:2022-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes364SP0808XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental HealthGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty