| Organization Name: | CCM SPECIALISTS LLC |
| NPI Number: | 1891183984 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | AJAY K DHAWAN (MEDICAL DIRECTOR) |
| Mailing Address: | 1108 Amber Lake Ct Cape Coral |
| State: | FL US |
| Postal Code: | 33909 |
| Phone Number: | 4252705432 |
| Fax Number: | |
| NPI Enumeration Date: | 12/26/2014 |
| NPI Last Update Date: | 12/26/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 171M00000X |
| License Number: | ME105093 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Other Service Providers |
| Taxonomy Classification: | Case Manager/Care Coordinator |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A person who provides case management services and assists an individual in gaining access to needed medical, social, educational, and/or other services. The person has the ability to provide an assessment and review of completed plan of care on a periodic basis. This person is also able to take collaborative action to coordinate the services with other providers and monitor the enrollee |