Provider Demographics
NPI:1477349249
Name:CARE SERVICE WORKFORCE APPRENTICESHIP PROGRAM
Entity type:Organization
Organization Name:CARE SERVICE WORKFORCE APPRENTICESHIP PROGRAM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER
Authorized Official - Prefix:MS
Authorized Official - First Name:WANDA
Authorized Official - Middle Name:L
Authorized Official - Last Name:ROGERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:619-303-6890
Mailing Address - Street 1:5505 STEVENS WAY # 742351
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92114-3970
Mailing Address - Country:US
Mailing Address - Phone:619-303-6890
Mailing Address - Fax:
Practice Address - Street 1:6125 IMPERIAL AVE
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92114-4213
Practice Address - Country:US
Practice Address - Phone:619-303-6890
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-17
Last Update Date:2025-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251300000XAgenciesLocal Education Agency (LEA)Group - Multi-Specialty
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Multi-Specialty
No251B00000XAgenciesCase Management
No302R00000XManaged Care OrganizationsHealth Maintenance Organization
No332H00000XSuppliersEyewear Supplier