Provider Demographics
NPI:1619303245
Name:CARES COMMUNITY AND RESIDENTIAL EMPOWERMENT SERVICES INC
Entity Type:Organization
Organization Name:CARES COMMUNITY AND RESIDENTIAL EMPOWERMENT SERVICES INC
Other - Org Name:CARES
Other - Org Type:Other Name
Authorized Official - Title/Position:CEO, PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:SHEILA
Authorized Official - Middle Name:
Authorized Official - Last Name:DAVISON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:570-778-0797
Mailing Address - Street 1:139 W BROAD ST
Mailing Address - Street 2:SUITE 102-CARES
Mailing Address - City:TAMAQUA
Mailing Address - State:PA
Mailing Address - Zip Code:18252-1960
Mailing Address - Country:US
Mailing Address - Phone:570-778-0797
Mailing Address - Fax:570-225-7360
Practice Address - Street 1:139 W BROAD ST
Practice Address - Street 2:SUITE 102-CARES
Practice Address - City:TAMAQUA
Practice Address - State:PA
Practice Address - Zip Code:18252-1960
Practice Address - Country:US
Practice Address - Phone:570-778-0797
Practice Address - Fax:570-225-7360
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-14
Last Update Date:2013-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA514Medicaid
PA515Medicaid
PA2390Medicaid
PA51Medicaid
PA522Medicaid
PA431Medicaid
PA2380Medicaid
PA26Medicaid
PA510Medicaid
PA52Medicaid
PA267Medicaid
PA512Medicaid
PA6500Medicaid
PA513Medicaid
PA516Medicaid