Provider Demographics
NPI:1982979779
Name:DIGITRACE CARE SERVICES, INC.
Entity Type:Organization
Organization Name:DIGITRACE CARE SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EVP/CAO
Authorized Official - Prefix:
Authorized Official - First Name:CARL
Authorized Official - Middle Name:R
Authorized Official - Last Name:IBERGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:978-536-7400
Mailing Address - Street 1:200 CORPORATE PL
Mailing Address - Street 2:SUITE 5B
Mailing Address - City:PEABODY
Mailing Address - State:MA
Mailing Address - Zip Code:01960-3840
Mailing Address - Country:US
Mailing Address - Phone:978-536-7400
Mailing Address - Fax:978-535-9757
Practice Address - Street 1:95 SOCKANOSSET CROSSROAD
Practice Address - Street 2:SUITE 107A
Practice Address - City:CRANSTON
Practice Address - State:RI
Practice Address - Zip Code:02920-5559
Practice Address - Country:US
Practice Address - Phone:401-831-1505
Practice Address - Fax:401-272-2646
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-13
Last Update Date:2012-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic