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General NPI Number Information
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NPI Number | 1336013887
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Entity Type | Organization
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Legal Business Name | COMMUNITY CARE TEAM MINISTRIES
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Dates
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Enumeration Date | 09/30/2025
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Last Update Date | 09/30/2025
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Provider Practice Location Address
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Address Line | 11115 CHICKEN DINNER RD
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City | CALDWELL
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State | ID
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Zip | 83607-9741
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Country | US
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Telephone | 208-250-9963
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 745
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City | MARSING
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State | ID
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Zip | 83639-0745
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Country | US
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Telephone | 208-250-9963
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | STEPHANIE COOKE
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Credential |
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Telephone | 208-250-9963
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 177F00000X
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Taxonomy Name | Lodging Provider
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License Number |
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License Number State |
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