MEDICARE: CARE & LEARNING CONNECTION CENTER 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
1	320900000X	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility

General Provider Information

NPI Number	:	1447979240
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CARE & LEARNING CONNECTION CENTER LLC

Provider Business Mailing Address
First Line	:	1817 PANNELL ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77020-2336
Country	:	US
Telephone Number	:	713-443-7517
Fax Number	:

Provider Business Practice Location Address
First Line	:	1817 PANNELL ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77020-2336
Country	:	US
Telephone Number	:	713-443-7517
Fax Number	:

Authorized Official
Title or Position	:	PROGRAM MANAGER
Name	:	CYNTHIA DIANE BROWN
Credential	:
Telephone Number	:	713-443-7517

Provider Enumeration Date	:	08/24/2022
Last Update Date	:	03/22/2023

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