Provider Demographics
NPI:1619260775
Name:CARE OPTIONS SUPPORT SERVICES, LLC
Entity Type:Organization
Organization Name:CARE OPTIONS SUPPORT SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:ARLENE
Authorized Official - Last Name:COBB
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:904-504-5032
Mailing Address - Street 1:3206 DE CARLO LN
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32277-3538
Mailing Address - Country:US
Mailing Address - Phone:904-504-5032
Mailing Address - Fax:904-743-7518
Practice Address - Street 1:3206 DE CARLO LN
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32277-3538
Practice Address - Country:US
Practice Address - Phone:904-504-5032
Practice Address - Fax:904-743-7518
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-24
Last Update Date:2011-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL690427196Medicaid
FL690427198Medicaid