Provider Demographics
NPI:1689097487
Name:CAREMERIDIAN, LLC
Entity Type:Organization
Organization Name:CAREMERIDIAN, LLC
Other - Org Name:CAREMERIDIAN - TEXHOMA
Other - Org Type:Other Name
Authorized Official - Title/Position:DIRECTOR OF FINANCE
Authorized Official - Prefix:MR
Authorized Official - First Name:SEAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SHEA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-688-5251
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 1:9440 TEXHOMA AVE
Practice Address - Street 2:
Practice Address - City:NORTHRIDGE
Practice Address - State:CA
Practice Address - Zip Code:91325-2333
Practice Address - Country:US
Practice Address - Phone:747-202-0334
Practice Address - Fax:949-266-8679
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THE MENTOR NETWORK, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-01-29
Last Update Date:2019-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility