Organization Name: | COMMUNITY CARE, INC |
NPI Number: | 1013079458 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | BENJAMIN WRIGHT (EXECUTIVE DRIECTOR) |
Mailing Address: | 108 Industrial St De Witt |
State: | IA US |
Postal Code: | 527422063 |
Phone Number: | 5636594100 |
Fax Number: | 5636591120 |
NPI Enumeration Date: | 12/14/2006 |
NPI Last Update Date: | 07/09/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 00254 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |