Provider Demographics
NPI:1295286862
Name:CARE PROVIDERS
Entity type:Organization
Organization Name:CARE PROVIDERS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MORDO
Authorized Official - Middle Name:
Authorized Official - Last Name:BONO
Authorized Official - Suffix:
Authorized Official - Credentials:CSA
Authorized Official - Phone:718-261-0158
Mailing Address - Street 1:8803 69TH AVE
Mailing Address - Street 2:SUITE 2
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-6667
Mailing Address - Country:US
Mailing Address - Phone:718-261-0158
Mailing Address - Fax:718-559-6425
Practice Address - Street 1:8803 69TH AVE
Practice Address - Street 2:SUITE 2
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375-6667
Practice Address - Country:US
Practice Address - Phone:718-261-0158
Practice Address - Fax:718-559-6425
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-19
Last Update Date:2016-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health