Basic Information
| Provider Information | |||||||||
| NPI: | 1013070150 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | CARE FOCUS, INC. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7227 LEE DEFOREST RD | ||||||||
| Address2: | |||||||||
| City: | COLUMBIA | ||||||||
| State: | MD | ||||||||
| PostalCode: | 210463236 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 6166 SHALLOWFORD RD | ||||||||
| Address2: | SUITE 105 | ||||||||
| City: | CHATTANOOGA | ||||||||
| State: | TN | ||||||||
| PostalCode: | 374217221 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4235535530 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 12/19/2006 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | BRICKHOUSE | ||||||||
| AuthorizedOfficialFirstName: | DUANE | ||||||||
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| AuthorizedOfficialTitleorPosition: | CONTROLLER | ||||||||
| AuthorizedOfficialTelephone: | 4109101500 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251S00000X | X | Agencies | Community/Behavioral Health | 251X00000X | X | Agencies | Supports Brokerage | 251C00000X | X | Agencies | Day Training, Developmentally Disabled Services | 3747P1801X | X | 193200000X MULTI-SPECIALTY GROUP | Nursing Service Related Providers | Technician | Personal Care Attendant | 171M00000X | X | 193200000X MULTI-SPECIALTY GROUP | Other Service Providers | Case Manager/Care Coordinator | 320800000X | X | Residential Treatment Facilities | Community Based Residential Treatment Facility, Mental Illness | 320900000X | X | Residential Treatment Facilities | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 320600000X | X | Residential Treatment Facilities | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 322D00000X | X | Residential Treatment Facilities | Residential Treatment Facility, Emotionally Disturbed Children |
ID Information
| ID | Type | State | Issuer | Description | OOD85 | 05 | TN | MEDICAID |