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NPI Code Detail

MEDICARE: 1ST COMMUNITY CARE CONNECTIONS LLC

MEDICARE: 1ST COMMUNITY CARE CONNECTIONS LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251B00000XCase Management Agency

General Provider Information

NPI Number : 1043911605
Entity Type Code : Organization
Provider Name (Legal Business Name) : 1ST COMMUNITY CARE CONNECTIONS LLC
Provider Business Mailing Address
First Line : 13327 LAKE ARLINGTON RD
Second Line :
City : HOUSTON
State : TX
Zip : 77044-1359
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4141 SOUTHWEST FWY STE 510
Second Line :
City : HOUSTON
State : TX
Zip : 77027-7334
Country : US
Telephone Number : 832-699-7921
Fax Number :
Authorized Official
Title or Position : CEO
Name : DESTINY MCCOY
Credential : LCSW
Telephone Number : 832-699-7921
Provider Enumeration Date : 03/10/2023
Last Update Date : 06/12/2026

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Directions to “1ST COMMUNITY CARE CONNECTIONS LLC ” Practice Location

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