Provider Demographics
NPI:1932806031
Name:CHARICARE INCORPORATED
Entity Type:Organization
Organization Name:CHARICARE INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:APRN
Authorized Official - Prefix:
Authorized Official - First Name:JULIET
Authorized Official - Middle Name:C
Authorized Official - Last Name:NWOKEDI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-202-9640
Mailing Address - Street 1:12809 FLAT CREEK DR
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-3105
Mailing Address - Country:US
Mailing Address - Phone:214-202-9640
Mailing Address - Fax:
Practice Address - Street 1:12809 FLAT CREEK DR
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77584-3105
Practice Address - Country:US
Practice Address - Phone:214-202-9640
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-09
Last Update Date:2023-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities