COMMUNITY CARE LINK OF THE CAROLINAS, INC (COMMUNITY CARE LINK) - NPI NUMBER 1518216142

Summary

Provider Name: COMMUNITY CARE LINK OF THE CAROLINAS, INC (COMMUNITY CARE LINK)

NPI Number: 1518216142

Clasification: Case Management (251B00000X)

Address:
756 TYVOLA RD
STE 136
CHARLOTTE, NC
ZIP 28217

Phone Number: (980) 322-7279



Detailed Information

COMMUNITY CARE LINK OF THE CAROLINAS, INC is a case management in Charlotte, NC. The provider is an organization that is responsible for providing case management services. The agency provides services which assist an individual in gaining access to needed medical, social, educational, and/or other services. Case management services may be used to locate, coordinate, and monitor necessary appropriate services. It may be used to encourage the use of cost-effective medical care by referrals to appropriate providers and to discourage over utilization of costly services. Case management may also serve to provide necessary coordination of non-medical services such as vocational rehabilitation, education, employment, when the services provided enable the individual to function at the highest level. The assigned NPI number for this provider is 1518216142 and is registered as an organization entity type.
The provider Is Doing Business As Community Care Link.

The provider's business address is:

756 TYVOLA RD
STE 136
CHARLOTTE, NC
ZIP 28217-588
Phone: (980) 322-7279
Fax: (866) 908-6945

The provider's authorized official is Montoya Christian Boyd .
The authorized official title is Exective Director and has the following contact phone number (980) 322-7279.

The enumeration date for this NPI number is 8/29/2012 and was last updated on 2/7/2013.

Map - Location of Practice

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Taxonomy Codes

The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1 251B00000X Case Management EN0829 SC Yes
2 251B00000X Case Management NC No

Other (Legacy) Identifiers

The following legacy identifiers are available for this provider:

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1 HIV CASE MGT MEDICAID NC

NPI Record

No. Field Name Field Value
1 NPI 1518216142
2 Entity Type Code 2
3 Employer Identification Number EIN
4 Provider Organization Name Legal Business Name COMMUNITY CARE LINK OF THE CAROLINAS, INC
5 Provider Other Organization Name COMMUNITY CARE LINK
6 Provider Other Organization Name Type Code 3
7 Provider First Line Business Practice Location Address 756 TYVOLA RD
8 Provider Second Line Business Practice Location Address STE 136
9 Provider Business Practice Location Address City Name CHARLOTTE
10 Provider Business Practice Location Address State Name NC
11 Provider Business Practice Location Address Postal Code 282173588
12 Provider Business Practice Location Address Country Code If outside U S US
13 Provider Business Practice Location Address Telephone Number 9803227279
14 Provider Business Practice Location Address Fax Number 8669086945
15 Provider Enumeration Date 8/29/2012
16 Last Update Date 2/7/2013
17 Authorized Official Last Name BOYD
18 Authorized Official First Name MONTOYA
19 Authorized Official Middle Name CHRISTIAN
20 Authorized Official Title or Position EXECTIVE DIRECTOR
21 Authorized Official Telephone Number 9803227279
22 Healthcare Provider Taxonomy Code 1 251B00000X
23 Provider License Number 1 EN0829
24 Provider License Number State Code 1 SC
25 Healthcare Provider Primary Taxonomy Switch 1 Y
26 Healthcare Provider Taxonomy Code 2 251B00000X
27 Provider License Number State Code 2 NC
28 Healthcare Provider Primary Taxonomy Switch 2 N
29 Other Provider Identifier 1 HIV CASE MGT
30 Other Provider Identifier Type Code 1 05
31 Other Provider Identifier State 1 NC
32 Is Organization Subpart N
33 Authorized Official Credential Text BSN,B.MSC

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This page was last updated on: 7/15/2014
All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.