Healthcare Provider Details

I. General information

NPI: 1033718606
Provider Name (Legal Business Name): COMMUNITY CONNECTIONS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/23/2020
Last Update Date: 07/18/2025
Certification Date: 07/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1800 CRAIG KLAWOCK HWY STE 241
CRAIG AK
99921-0678
US

IV. Provider business mailing address

721 STEDMAN ST
KETCHIKAN AK
99901-6632
US

V. Phone/Fax

Practice location:
  • Phone: 907-826-3891
  • Fax: 907-826-3892
Mailing address:
  • Phone: 907-225-7825
  • Fax: 907-225-1541

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier1712659
Identifier TypeMEDICAID
Identifier StateAK
Identifier Issuer

VIII. Authorized Official

Name: TANDRA THOMPSON
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 907-225-7825