Provider Demographics
NPI:1922049808
Name:CONFIDENTIAL CARE, LTD.
Entity Type:Organization
Organization Name:CONFIDENTIAL CARE, LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:SANKER
Authorized Official - Middle Name:
Authorized Official - Last Name:JAYACHANDRAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:219-934-6410
Mailing Address - Street 1:8951 BONITA BEACH RD STE 525
Mailing Address - Street 2:PMB 312
Mailing Address - City:BONITA SPGS
Mailing Address - State:FL
Mailing Address - Zip Code:34135-4208
Mailing Address - Country:US
Mailing Address - Phone:219-934-6410
Mailing Address - Fax:219-881-8777
Practice Address - Street 1:1650 45TH ST STE C
Practice Address - Street 2:
Practice Address - City:MUNSTER
Practice Address - State:IN
Practice Address - Zip Code:46321-3960
Practice Address - Country:US
Practice Address - Phone:219-934-6410
Practice Address - Fax:219-881-8777
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-09
Last Update Date:2023-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200419260AMedicaid
IN407420Medicare ID - Type Unspecified