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General NPI Number Information
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NPI Number | 1679632145
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Entity Type | Organization
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Legal Business Name | COMMUNITY CARE CONNECTIONS INC.
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Dates
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Enumeration Date | 12/08/2006
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Last Update Date | 12/24/2007
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Provider Practice Location Address
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Address Line | 114 SKYLINE LN
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City | BUTLER
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State | PA
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Zip | 16001-8762
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Country | US
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Telephone | 724-283-3198
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Fax | 724-283-5945
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Provider Business Mailing Address
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Address Line | 114 SKYLINE LN
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City | BUTLER
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State | PA
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Zip | 16001-8762
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Country | US
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Telephone | 724-283-3198
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Fax | 724-283-5945
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | PAT BRENNEN
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Credential |
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Telephone | 724-283-3198
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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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 | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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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 | 231H00000X
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Taxonomy Name | Audiologist
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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 | 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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