Provider Demographics
| NPI: | 1215350764 |
|---|---|
| Name: | CARE TRUST RESEARCH INSTITUTE, INC. |
| Entity type: | Organization |
| Organization Name: | CARE TRUST RESEARCH INSTITUTE, INC. |
| Other - Org Name: | |
| Other - Org Type: | |
| Authorized Official - Title/Position: | CHIEF EXECUTIVE OFFICER |
| Authorized Official - Prefix: | MR |
| Authorized Official - First Name: | GARY |
| Authorized Official - Middle Name: | LEBRONE |
| Authorized Official - Last Name: | WILLIAMS |
| Authorized Official - Suffix: | |
| Authorized Official - Credentials: | |
| Authorized Official - Phone: | 305-772-3068 |
| Mailing Address - Street 1: | 1425 NW 59TH ST |
| Mailing Address - Street 2: | |
| Mailing Address - City: | MIAMI |
| Mailing Address - State: | FL |
| Mailing Address - Zip Code: | 33142-2519 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 305-772-3068 |
| Mailing Address - Fax: | |
| Practice Address - Street 1: | 1425 NW 59TH ST |
| Practice Address - Street 2: | |
| Practice Address - City: | MIAMI |
| Practice Address - State: | FL |
| Practice Address - Zip Code: | 33142-2519 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 305-772-3068 |
| Practice Address - Fax: | |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | No |
| Parent Organization LBN: | |
| Parent Organization TIN: | |
| Enumeration Date: | 2014-02-03 |
| Last Update Date: | 2014-02-03 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization |
|---|---|---|---|---|
| Yes | 320600000X | Residential Treatment Facilities | Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| No | 320900000X | Residential Treatment Facilities | Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| No | 322D00000X | Residential Treatment Facilities | Residential Treatment Facility, Emotionally Disturbed Children | |
| No | 323P00000X | Residential Treatment Facilities | Psychiatric Residential Treatment Facility | |
| No | 3245S0500X | Residential Treatment Facilities | Substance Abuse Rehabilitation Facility | Substance Abuse Treatment, Children |
| No | 347B00000X | Transportation Services | Bus | |
| No | 347C00000X | Transportation Services | Private Vehicle | |
| No | 385HR2055X | Respite Care Facility | Respite Care | Respite Care, Mental Illness, Child |
| No | 385HR2060X | Respite Care Facility | Respite Care | Respite Care, Intellectual and/or Developmental Disabilities, Child |
