Provider Demographics
NPI:1689832644
Name:BROTHERS THAT CARE INC
Entity Type:Organization
Organization Name:BROTHERS THAT CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:WADE
Authorized Official - Middle Name:R
Authorized Official - Last Name:O'BEAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:225-687-0396
Mailing Address - Street 1:PO BOX 153
Mailing Address - Street 2:
Mailing Address - City:WHITE CASTLE
Mailing Address - State:LA
Mailing Address - Zip Code:70788-0153
Mailing Address - Country:US
Mailing Address - Phone:225-687-0396
Mailing Address - Fax:225-687-0396
Practice Address - Street 1:55265 CAMBRE ST
Practice Address - Street 2:
Practice Address - City:WHITE CASTLE
Practice Address - State:LA
Practice Address - Zip Code:70788-2112
Practice Address - Country:US
Practice Address - Phone:225-687-0396
Practice Address - Fax:225-687-0396
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-27
Last Update Date:2008-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children