Provider Demographics
NPI:1063232577
Name:CARE STREAM LLC
Entity type:Organization
Organization Name:CARE STREAM LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SINA
Authorized Official - Middle Name:
Authorized Official - Last Name:BEHMANESH
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:703-728-8572
Mailing Address - Street 1:18502 PELICANS NEST WAY
Mailing Address - Street 2:
Mailing Address - City:LEESBURG
Mailing Address - State:VA
Mailing Address - Zip Code:20176-3963
Mailing Address - Country:US
Mailing Address - Phone:703-728-8572
Mailing Address - Fax:
Practice Address - Street 1:18502 PELICANS NEST WAY
Practice Address - Street 2:
Practice Address - City:LEESBURG
Practice Address - State:VA
Practice Address - Zip Code:20176-3963
Practice Address - Country:US
Practice Address - Phone:703-728-8572
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-10
Last Update Date:2024-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental