Provider Demographics
NPI:1639334659
Name:CARE LIFE OUTREACH INC.
Entity Type:Organization
Organization Name:CARE LIFE OUTREACH INC.
Other - Org Name:A PLUS MEDICAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RENAY
Authorized Official - Middle Name:
Authorized Official - Last Name:PROENZA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:386-960-8392
Mailing Address - Street 1:2578 ENTERPRISE RD
Mailing Address - Street 2:# 305
Mailing Address - City:ORANGE CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32763-7904
Mailing Address - Country:US
Mailing Address - Phone:386-960-8392
Mailing Address - Fax:386-774-5275
Practice Address - Street 1:100 TREEMONT DR
Practice Address - Street 2:
Practice Address - City:ORANGE CITY
Practice Address - State:FL
Practice Address - Zip Code:32763-7953
Practice Address - Country:US
Practice Address - Phone:386-960-8392
Practice Address - Fax:386-774-5275
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-21
Last Update Date:2008-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies