Provider Demographics
NPI:1972768893
Name:CAROLINA'S CARE CENTER CORP.
Entity type:Organization
Organization Name:CAROLINA'S CARE CENTER CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMIN
Authorized Official - Prefix:
Authorized Official - First Name:SILVESTRE
Authorized Official - Middle Name:E
Authorized Official - Last Name:SOCARRAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-985-3040
Mailing Address - Street 1:9024 NW 148TH ST.
Mailing Address - Street 2:
Mailing Address - City:MIAMI LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33018
Mailing Address - Country:US
Mailing Address - Phone:305-827-3100
Mailing Address - Fax:305-558-9452
Practice Address - Street 1:9024 NW 148TH ST.
Practice Address - Street 2:
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33018
Practice Address - Country:US
Practice Address - Phone:305-827-3100
Practice Address - Fax:305-558-9452
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-21
Last Update Date:2018-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL8220310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL141995100Medicaid