Provider Demographics
NPI:1053430629
Name:CARE CONTINUUM, INC. DBA HERITAGE CARE GROUP
Entity type:Organization
Organization Name:CARE CONTINUUM, INC. DBA HERITAGE CARE GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE-PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:VALARIE
Authorized Official - Middle Name:J
Authorized Official - Last Name:FANE
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:248-358-5334
Mailing Address - Street 1:29877 TELEGRAPH RD
Mailing Address - Street 2:SUITE 401
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48034-1332
Mailing Address - Country:US
Mailing Address - Phone:248-358-5334
Mailing Address - Fax:248-356-7596
Practice Address - Street 1:29877 TELEGRAPH RD
Practice Address - Street 2:SUITE 401
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48034-1332
Practice Address - Country:US
Practice Address - Phone:248-358-5334
Practice Address - Fax:248-356-7596
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MION52360Medicare PIN