Provider Demographics
NPI:1134796824
Name:ECARE CLINIC
Entity type:Organization
Organization Name:ECARE CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMIN
Authorized Official - Prefix:
Authorized Official - First Name:MANAL
Authorized Official - Middle Name:
Authorized Official - Last Name:CCCCCCC
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:877-882-4480
Mailing Address - Street 1:5820 N CANTON CENTER RD STE 180
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:MI
Mailing Address - Zip Code:48187-2680
Mailing Address - Country:US
Mailing Address - Phone:877-882-4480
Mailing Address - Fax:248-800-7272
Practice Address - Street 1:5820 N CANTON CENTER RD STE 180
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:MI
Practice Address - Zip Code:48187-2680
Practice Address - Country:US
Practice Address - Phone:877-882-4480
Practice Address - Fax:248-800-7272
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-10
Last Update Date:2023-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QI0500XAmbulatory Health Care FacilitiesClinic/CenterInfusion Therapy
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
No251F00000XAgenciesHome Infusion
No251G00000XAgenciesHospice Care, Community Based
No251V00000XAgenciesVoluntary or Charitable
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth ServiceGroup - Multi-Specialty
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-SpecialtyGroup - Multi-Specialty
No261QP1100XAmbulatory Health Care FacilitiesClinic/CenterPodiatricGroup - Multi-Specialty
No261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
No261QR1100XAmbulatory Health Care FacilitiesClinic/CenterResearch
No261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
No385HR2055XRespite Care FacilityRespite CareRespite Care, Mental Illness, ChildGroup - Multi-Specialty