Provider Demographics
NPI:1174344774
Name:CAREONE SUPPORT SERVICES, LLC
Entity type:Organization
Organization Name:CAREONE SUPPORT SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CAO / PROGRAM DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:QUENTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:PHILLIPS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-539-7532
Mailing Address - Street 1:218 ALGIERS DR
Mailing Address - Street 2:
Mailing Address - City:SANDSTON
Mailing Address - State:VA
Mailing Address - Zip Code:23150-1603
Mailing Address - Country:US
Mailing Address - Phone:804-539-7532
Mailing Address - Fax:
Practice Address - Street 1:218 ALGIERS DR
Practice Address - Street 2:
Practice Address - City:SANDSTON
Practice Address - State:VA
Practice Address - Zip Code:23150-1603
Practice Address - Country:US
Practice Address - Phone:804-539-7532
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-17
Last Update Date:2024-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
No251J00000XAgenciesNursing Care