Healthcare Provider Details

I. General information

NPI: 1194063388
Provider Name (Legal Business Name): COMMUNITY CARE SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/22/2013
Last Update Date: 01/22/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

70 MAIN ST
TAUNTON MA
02780-2778
US

IV. Provider business mailing address

70 MAIN ST
TAUNTON MA
02780-2778
US

V. Phone/Fax

Practice location:
  • Phone: 508-821-7777
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. BOB FRAZIER
Title or Position: CLINIC DIRECTOR
Credential: PHD
Phone: 508-821-7777