Healthcare Provider Details

I. General information

NPI: 1326825951
Provider Name (Legal Business Name): COMPLETE CONNECTIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/08/2023
Last Update Date: 03/26/2024
Certification Date: 03/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

517 BARTOLI CT
SIMPSONVILLE SC
29680-7482
US

IV. Provider business mailing address

517 BARTOLI CT
SIMPSONVILLE SC
29680-7482
US

V. Phone/Fax

Practice location:
  • Phone: 252-402-0513
  • Fax:
Mailing address:
  • Phone: 252-402-0513
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JESSICA ANN VOGT
Title or Position: OWNER/BCBA
Credential: MA, BCBA
Phone: 252-402-0513