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General NPI Number Information
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NPI Number | 1275824864
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Entity Type | Organization
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Legal Business Name | DIVERSIFIED COMMUNITY CONNECTIONS,LLC
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Dates
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Enumeration Date | 04/29/2011
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Last Update Date | 05/02/2011
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Provider Practice Location Address
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Address Line | 1112 NAI RAD LN
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City | WILLIAMSTON
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State | NC
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Zip | 27892-7897
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Country | US
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Telephone | 252-508-4445
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Fax | 252-508-4445
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Provider Business Mailing Address
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Address Line | PO BOX 504
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City | WILLIAMSTON
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State | NC
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Zip | 27892-0504
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Country | US
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Telephone | 252-508-4445
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Fax | 252-508-4445
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Authorized Official
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Title or Position | CEO
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Name | MRS. SANDRA ALSTON ADAMS
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Credential |
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Telephone | 252-623-9942
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 171R00000X
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Taxonomy Name | Interpreter
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 172A00000X
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Taxonomy Name | Driver
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 172V00000X
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Taxonomy Name | Community Health Worker
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 174H00000X
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Taxonomy Name | Health Educator
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License Number |
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License Number State |
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Taxonomy #9
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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Taxonomy #10
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number |
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License Number State |
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Taxonomy #11
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Taxonomy Code | 251K00000X
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Taxonomy Name | Public Health or Welfare Agency
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License Number |
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License Number State |
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Taxonomy #12
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Taxonomy Code | 251X00000X
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Taxonomy Name | Supports Brokerage Agency
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License Number |
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License Number State |
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Taxonomy #13
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Taxonomy Code | 252Y00000X
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Taxonomy Name | Early Intervention Provider Agency
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License Number |
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License Number State |
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Taxonomy #14
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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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