Provider Demographics
NPI:1528798410
Name:CARE CENTRAL PROFESSIONALS LLC
Entity type:Organization
Organization Name:CARE CENTRAL PROFESSIONALS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KRISDEL
Authorized Official - Middle Name:
Authorized Official - Last Name:ROBERTO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-774-7599
Mailing Address - Street 1:3017 DOUGLAS BLVD STE 300-56
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95661-3848
Mailing Address - Country:US
Mailing Address - Phone:916-774-7599
Mailing Address - Fax:
Practice Address - Street 1:3017 DOUGLAS BLVD STE 300
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95661-3850
Practice Address - Country:US
Practice Address - Phone:916-774-7599
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-14
Last Update Date:2024-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health