COMMUNITY CARE CENTER INC NPI 1093712754

NPI Information

NPI: 1093712754
Provider Name: COMMUNITY CARE CENTER INC
Classification: Counselor - 101YA0400X
Entity Type: Organization

Specialization: Addiction (Substance Use Disorder)

Address:
110 S QUEEN ST
110 SOUTH QUEEN STREET SUITE 118
KINSTON, NC
ZIP 28501
Phone: (252) 208-1928
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COMMUNITY CARE CENTER INC is an addiction (substance use disorder) counselor in Kinston, NC. COMMUNITY CARE CENTER INC NPI is 1093712754. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

110 S QUEEN ST
110 SOUTH QUEEN STREET SUITE 118
KINSTON, NC
ZIP 28501-975
Phone: (252) 208-1928
Fax: (252) 559-2055

The provider's authorized official is Esau Arnold Mcmorris .
The authorized official title is President and has the following contact phone number (252) 208-1928.

The enumeration date for this NPI number is 7/7/2005 and was last updated on 8/22/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. 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	101YA0400X	Counselor	Addiction (Substance Use Disorder)	101YA00000X	NORTH CAROLINA	Yes
2	302R00000X	Health Maintenance Organization		8700395	NORTH CAROLINA	X

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	6111780	MEDICAID	NORTH CAROLINA
2	8700395	MEDICAID	NEW YORK

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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