Provider Demographics
NPI:1609665066
Name:PROFOUND CARE LLC
Entity type:Organization
Organization Name:PROFOUND CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:VALERIE
Authorized Official - Middle Name:
Authorized Official - Last Name:CARABALLO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:914-618-4321
Mailing Address - Street 1:5240 NETHERLAND AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10471-2810
Mailing Address - Country:US
Mailing Address - Phone:718-884-6547
Mailing Address - Fax:
Practice Address - Street 1:3300 STEUBEN AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10467-2806
Practice Address - Country:US
Practice Address - Phone:914-618-4321
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:INTRACARES LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-05-02
Last Update Date:2025-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251X00000XAgenciesSupports Brokerage