Provider Demographics
NPI:1366704116
Name:THERACARE
Entity type:Organization
Organization Name:THERACARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EVALUATION COORDINATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:MAYER
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:718-966-4552
Mailing Address - Street 1:926 47TH ST
Mailing Address - Street 2:APT D1
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11219-2861
Mailing Address - Country:US
Mailing Address - Phone:718-864-7721
Mailing Address - Fax:718-972-1493
Practice Address - Street 1:926 47TH ST
Practice Address - Street 2:APT D1
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11219-2861
Practice Address - Country:US
Practice Address - Phone:718-864-7721
Practice Address - Fax:718-972-1493
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-07
Last Update Date:2012-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)