Provider Demographics
NPI:1871066464
Name:UNIVERSAL CARE SERVICES LLC
Entity type:Organization
Organization Name:UNIVERSAL CARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:FAITH
Authorized Official - Middle Name:C
Authorized Official - Last Name:TABUKUM
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:856-426-3416
Mailing Address - Street 1:101 E GIBBSBORO RD APT 1403
Mailing Address - Street 2:
Mailing Address - City:LINDENWOLD
Mailing Address - State:NJ
Mailing Address - Zip Code:08021-1921
Mailing Address - Country:US
Mailing Address - Phone:856-426-3416
Mailing Address - Fax:
Practice Address - Street 1:101 E GIBBSBORO RD APT 1403
Practice Address - Street 2:
Practice Address - City:LINDENWOLD
Practice Address - State:NJ
Practice Address - Zip Code:08021-1921
Practice Address - Country:US
Practice Address - Phone:856-426-3416
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-07
Last Update Date:2019-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health