Provider Demographics
NPI:1134584824
Name:CAREMERIDIAN, LLC
Entity type:Organization
Organization Name:CAREMERIDIAN, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF FINANCE
Authorized Official - Prefix:MR
Authorized Official - First Name:SEAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SHEA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-688-5251
Mailing Address - Street 1:163 TECHNOLOGY DR STE 200
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92618-2486
Mailing Address - Country:US
Mailing Address - Phone:949-794-0787
Mailing Address - Fax:949-261-0457
Practice Address - Street 1:7732 E SANTIAGO CANYON RD
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92869-1829
Practice Address - Country:US
Practice Address - Phone:714-771-5276
Practice Address - Fax:714-771-1452
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NATIONAL MENTOR HEALTHCARE, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-12-22
Last Update Date:2019-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA306004785261QA0600X
CA306004784320700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320700000XResidential Treatment FacilitiesResidential Treatment Facility, Physical Disabilities
No261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA306004784OtherLICENSE NUMBER - ADULT RESIDENTIAL
CA306004785OtherLICENSE NUMBER - ADULT DAY CARE