Provider Demographics
NPI:1609306091
Name:CAREMERIDIAN, LLC
Entity Type:Organization
Organization Name:CAREMERIDIAN, LLC
Other - Org Name:NEURORESTORATIVE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP & SR. ASST GC
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:PATRICIA
Authorized Official - Last Name:RODENBERG-ROBERTS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:952-836-2234
Mailing Address - Street 1:163 TECHNOLOGY DR STE 200
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92618-2486
Mailing Address - Country:US
Mailing Address - Phone:949-263-6632
Mailing Address - Fax:949-266-8679
Practice Address - Street 1:13747 S REDWOOD RD
Practice Address - Street 2:
Practice Address - City:RIVERTON
Practice Address - State:UT
Practice Address - Zip Code:84065-5710
Practice Address - Country:US
Practice Address - Phone:801-417-9400
Practice Address - Fax:801-417-9398
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NATIONAL MENTOR HEALTHCARE LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-06-18
Last Update Date:2023-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility