Healthcare Provider Details

I. General information

NPI: 1982493730
Provider Name (Legal Business Name): COMMUNITY COMPANION SERVICES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/06/2025
Last Update Date: 05/06/2025
Certification Date: 05/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

455 CRESCENT ST # 1F
BROOKLYN NY
11208-2801
US

IV. Provider business mailing address

455 CRESCENT ST # 1F
BROOKLYN NY
11208-2801
US

V. Phone/Fax

Practice location:
  • Phone: 516-262-0072
  • Fax:
Mailing address:
  • Phone: 516-262-0072
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code315D00000X
TaxonomyInpatient Hospice
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State

VIII. Authorized Official

Name: ERROL STEPHENSON
Title or Position: CEO
Credential: MD
Phone: 516-262-0072