MEDICARE: CENTRAL CONNECTIONS, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251B00000X	Case Management Agency		MO

General Provider Information

NPI Number	:	1346784972
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CENTRAL CONNECTIONS, INC

Provider Business Mailing Address
First Line	:	1908 BOGGS CREEK RD
Second Line	:
City	:	JEFFERSON CITY
State	:	MO
Zip	:	65101-5580
Country	:	US
Telephone Number	:	573-634-4555
Fax Number	:

Provider Business Practice Location Address
First Line	:	1908 BOGGS CREEK RD
Second Line	:
City	:	JEFFERSON CITY
State	:	MO
Zip	:	65101-5580
Country	:	US
Telephone Number	:	573-634-4555
Fax Number	:

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	MRS. TRACY JO AUXIER
Credential	:
Telephone Number	:	573-634-4555

Provider Enumeration Date	:	12/16/2016
Last Update Date	:	12/16/2016

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