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General NPI Number Information
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NPI Number | 1073436747
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Entity Type | Organization
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Legal Business Name | CORE CARE COMMUNITY SERVICES
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Dates
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Enumeration Date | 07/31/2026
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Last Update Date | 07/31/2026
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Provider Practice Location Address
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Address Line | 4701 OWENS WAY
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City | PRINCE GEORGE
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State | VA
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Zip | 23875-2366
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Country | US
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Telephone | 804-930-4890
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 294
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City | MCDONOUGH
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State | GA
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Zip | 30253-0294
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Country | US
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Telephone | 804-930-4890
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | KEASIA MONIQUE DAY
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Credential |
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Telephone | 804-930-4890
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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