Provider Demographics
NPI:1962387704
Name:CORECARE BEHAVORIAL SERVICES LLC
Entity type:Organization
Organization Name:CORECARE BEHAVORIAL SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LAMBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:OBENSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-225-5545
Mailing Address - Street 1:7960 DONEGAN DR STE 201
Mailing Address - Street 2:
Mailing Address - City:MANASSAS
Mailing Address - State:VA
Mailing Address - Zip Code:20109-8236
Mailing Address - Country:US
Mailing Address - Phone:703-298-3429
Mailing Address - Fax:
Practice Address - Street 1:7960 DONEGAN DR STE 201
Practice Address - Street 2:
Practice Address - City:MANASSAS
Practice Address - State:VA
Practice Address - Zip Code:20109-8236
Practice Address - Country:US
Practice Address - Phone:703-298-3429
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-11
Last Update Date:2025-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care