Organization Name: | COMMUNITY CHRISTIAN COUNSELING CENTER |
NPI Number: | 1043304918 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | WILLIAM G LARRISON (EXECUTIVE DIRECTOR) |
Mailing Address: | 9625 North Military Trail Palm Beach Gardens |
State: | FL US |
Postal Code: | 33410 |
Phone Number: | 5616225423 |
Fax Number: | 5616225467 |
NPI Enumeration Date: | 10/03/2006 |
NPI Last Update Date: | 12/07/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP1600X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Pastoral |
Taxonomy Definition: |