Provider Demographics
NPI:1629023056
Name:CARE DIMENSIONS, LLC
Entity Type:Organization
Organization Name:CARE DIMENSIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:LAUREN
Authorized Official - Middle Name:TRAM
Authorized Official - Last Name:PHAN
Authorized Official - Suffix:
Authorized Official - Credentials:N/A
Authorized Official - Phone:714-619-8766
Mailing Address - Street 1:16162 BEACH BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92647-3807
Mailing Address - Country:US
Mailing Address - Phone:714-619-8766
Mailing Address - Fax:714-439-9603
Practice Address - Street 1:16162 BEACH BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92647-3807
Practice Address - Country:US
Practice Address - Phone:714-619-8766
Practice Address - Fax:714-439-9603
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-24
Last Update Date:2016-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA060000912251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1629023056Medicaid
CA1629023056Medicaid