Healthcare Provider Details

I. General information

NPI: 1093712754
Provider Name (Legal Business Name): COMMUNITY CARE CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/07/2005
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 S QUEEN ST 110 SOUTH QUEEN STREET SUITE 118
KINSTON NC
28501-4975
US

IV. Provider business mailing address

PO BOX 3392
KINSTON NC
28502-3392
US

V. Phone/Fax

Practice location:
  • Phone: 252-208-1928
  • Fax: 252-559-2055
Mailing address:
  • Phone: 252-208-1928
  • Fax: 252-559-2055

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code302R00000X
TaxonomyHealth Maintenance Organization
License Number8700395
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number101YA00000X
License Number StateNC

VIII. Authorized Official

Name: MR. ESAU ARNOLD MCMORRIS
Title or Position: PRESIDENT
Credential: C.M.
Phone: 252-208-1928