Provider Demographics
NPI:1720607377
Name:CARE RESOURCE COMMUNITY HEALTH CENTERS, INC.
Entity Type:Organization
Organization Name:CARE RESOURCE COMMUNITY HEALTH CENTERS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:SICLARI
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:305-573-1234
Mailing Address - Street 1:3510 BISCAYNE BLVD
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33137-3840
Mailing Address - Country:US
Mailing Address - Phone:305-576-1234
Mailing Address - Fax:
Practice Address - Street 1:3160 POWERLINE RD
Practice Address - Street 2:
Practice Address - City:OAKLAND PARK
Practice Address - State:FL
Practice Address - Zip Code:33309-5911
Practice Address - Country:US
Practice Address - Phone:305-576-1234
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CARE RESOURCE COMMUNITY HEALTH CENTERS INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-04-14
Last Update Date:2020-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
No251S00000XAgenciesCommunity/Behavioral Health