Provider Demographics
NPI: | 1457892762 |
---|---|
Name: | CARE HOLDINGS, LLC |
Entity Type: | Organization |
Organization Name: | CARE HOLDINGS, LLC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | PRESIDENT |
Authorized Official - Prefix: | |
Authorized Official - First Name: | DELENA |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | KESTO |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 904-304-7868 |
Mailing Address - Street 1: | 21700 NORTHWESTERN HWY |
Mailing Address - Street 2: | SUITE 870 |
Mailing Address - City: | SOUTHFIELD |
Mailing Address - State: | MI |
Mailing Address - Zip Code: | 48075-4906 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 904-304-7868 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 21700 NORTHWESTERN HWY |
Practice Address - Street 2: | SUITE 870 |
Practice Address - City: | SOUTHFIELD |
Practice Address - State: | MI |
Practice Address - Zip Code: | 48075-4906 |
Practice Address - Country: | US |
Practice Address - Phone: | 904-304-7868 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2017-03-20 |
Last Update Date: | 2017-03-20 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
MI | 103K00000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 103K00000X | Behavioral Health & Social Service Providers | Behavior Analyst | Group - Single Specialty |