Provider Demographics
NPI:1790188902
Name:I-KARE TREATMENT CENTER, LLC
Entity Type:Organization
Organization Name:I-KARE TREATMENT CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:NICHOLE
Authorized Official - Middle Name:
Authorized Official - Last Name:GARY
Authorized Official - Suffix:
Authorized Official - Credentials:NCRC, NCCM, BS(PSY)
Authorized Official - Phone:561-331-8453
Mailing Address - Street 1:1720 E TIFFANY DR STE 101
Mailing Address - Street 2:
Mailing Address - City:MANGONIA PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33407-3235
Mailing Address - Country:US
Mailing Address - Phone:561-331-8453
Mailing Address - Fax:954-208-0462
Practice Address - Street 1:1720 E TIFFANY DR STE 101
Practice Address - Street 2:
Practice Address - City:MANGONIA PARK
Practice Address - State:FL
Practice Address - Zip Code:33407-3235
Practice Address - Country:US
Practice Address - Phone:561-331-8453
Practice Address - Fax:954-208-0462
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-01
Last Update Date:2022-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health