Provider Demographics
NPI:1922553981
Name:CARIDAD INDEPENDENT LIVING LLC
Entity Type:Organization
Organization Name:CARIDAD INDEPENDENT LIVING LLC
Other - Org Name:CARIDAD INDEPENDENT LIVING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARVEL
Authorized Official - Middle Name:
Authorized Official - Last Name:LAROSE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:857-991-0110
Mailing Address - Street 1:73 CEDAR ST
Mailing Address - Street 2:SUITE 1
Mailing Address - City:ROXBURY
Mailing Address - State:MA
Mailing Address - Zip Code:02119-1428
Mailing Address - Country:US
Mailing Address - Phone:885-991-0110
Mailing Address - Fax:
Practice Address - Street 1:73 CEDAR ST
Practice Address - Street 2:SUITE 1
Practice Address - City:ROXBURY
Practice Address - State:MA
Practice Address - Zip Code:02119-1428
Practice Address - Country:US
Practice Address - Phone:885-991-0110
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-19
Last Update Date:2019-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No253J00000XAgenciesFoster Care Agency