Provider Demographics
NPI:1831352129
Name:CARE SUPPORT OF AMERICA
Entity type:Organization
Organization Name:CARE SUPPORT OF AMERICA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DAN
Authorized Official - Middle Name:
Authorized Official - Last Name:TOBIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:518-626-6088
Mailing Address - Street 1:113 HOLLAND AVE # 11T
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12208-3410
Mailing Address - Country:US
Mailing Address - Phone:518-626-6125
Mailing Address - Fax:518-626-6128
Practice Address - Street 1:113 HOLLAND AVE # 11T
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12208-3410
Practice Address - Country:US
Practice Address - Phone:518-626-6125
Practice Address - Fax:518-626-6128
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CARE SUPPORT OF AMERICA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-07-07
Last Update Date:2008-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management