Organization
COREY KARE HOME & COMMUNITY SUPPORT SERVICES, LLC
Active
Organization
COREY KARE HOME & COMMUNITY SUPPORT SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RODERICK GERMAINE DIXON SR. (OWNER)
(772) 216-8314
Entity
Organization
Contact information
Practice address
5101 NW NEWARK LN, PORT SAINT LUCIE, FL 34983-5369
(772) 344-8482
(772) 344-8482
Mailing address
5101 NW NEWARK LN, PORT SAINT LUCIE, FL 34983-5369
(772) 344-8482
(772) 344-8482
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
229501
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
688595196
—
FL
05
—
688595198
—
FL
Enumeration date
07/17/2006
Last updated
05/10/2009
Update your record
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