Provider Demographics
NPI:1558356592
Name:CAROCARE HEALTHCARE SERVICES, INC.
Entity Type:Organization
Organization Name:CAROCARE HEALTHCARE SERVICES, INC.
Other - Org Name:CAROCARE PEDIATRIC HEALTHCARE SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:CAROLINE
Authorized Official - Middle Name:O
Authorized Official - Last Name:OKPARA
Authorized Official - Suffix:
Authorized Official - Credentials:RN, BSN, MS
Authorized Official - Phone:713-668-8636
Mailing Address - Street 1:6065 HILLCROFT ST
Mailing Address - Street 2:SUITE 300
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77081-1087
Mailing Address - Country:US
Mailing Address - Phone:713-668-8636
Mailing Address - Fax:713-668-8187
Practice Address - Street 1:6065 HILLCROFT ST
Practice Address - Street 2:SUITE 300
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77081-1087
Practice Address - Country:US
Practice Address - Phone:713-668-8636
Practice Address - Fax:713-668-8187
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-15
Last Update Date:2015-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX679135251E00000X
TX108365103251E00000X
TX251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX108365103Medicaid
TX108365103Medicaid