Provider Demographics
NPI:1932491800
Name:CARE POSITIVE
Entity Type:Organization
Organization Name:CARE POSITIVE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:VICTOR
Authorized Official - Middle Name:O
Authorized Official - Last Name:OKE
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:301-466-2046
Mailing Address - Street 1:10435 EDGEFIELD DR
Mailing Address - Street 2:
Mailing Address - City:ADELPHI
Mailing Address - State:MD
Mailing Address - Zip Code:20783-1127
Mailing Address - Country:US
Mailing Address - Phone:301-439-1810
Mailing Address - Fax:301-920-2092
Practice Address - Street 1:10435 EDGEFIELD DRIVE
Practice Address - Street 2:
Practice Address - City:ADELPHI
Practice Address - State:MD
Practice Address - Zip Code:20783
Practice Address - Country:US
Practice Address - Phone:301-439-1810
Practice Address - Fax:301-920-2092
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-10
Last Update Date:2016-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR2957251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD7253028-00Medicaid