Provider Demographics
NPI:1184074379
Name:CARE CENTERED LLC
Entity type:Organization
Organization Name:CARE CENTERED LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:FRANCIS
Authorized Official - Last Name:LICA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-854-6756
Mailing Address - Street 1:5850 CORAL RIDGE DR
Mailing Address - Street 2:SUITE 302
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33076-3378
Mailing Address - Country:US
Mailing Address - Phone:877-639-3613
Mailing Address - Fax:
Practice Address - Street 1:5850 CORAL RIDGE DR
Practice Address - Street 2:SUITE 302
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33076-3378
Practice Address - Country:US
Practice Address - Phone:877-639-3613
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-17
Last Update Date:2016-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL78028261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center