Provider Demographics
NPI:1265935050
Name:CARING CLOSELY PROVIDERS
Entity type:Organization
Organization Name:CARING CLOSELY PROVIDERS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:RONIKA
Authorized Official - Middle Name:MONAE
Authorized Official - Last Name:MARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-890-7733
Mailing Address - Street 1:2881 S SANDHILL RD APT 101
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89121-1741
Mailing Address - Country:US
Mailing Address - Phone:702-890-7733
Mailing Address - Fax:
Practice Address - Street 1:2881 S SANDHILL RD APT 101
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89121-1741
Practice Address - Country:US
Practice Address - Phone:702-890-7733
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-17
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness