MEDICARE: CONNECTIONS BWB 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	253J00000X	Foster Care Agency	150	NC
2	251S00000X	Community/Behavioral Health Agency

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1477870061
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CONNECTIONS BWB INC

Provider Business Mailing Address
First Line	:	8430 UNIVERSITY EXEC PARK DR
Second Line	:	SUITE 655
City	:	CHARLOTTE
State	:	NC
Zip	:	28262-1350
Country	:	US
Telephone Number	:	704-596-5553
Fax Number	:	704-596-1556

Provider Business Practice Location Address
First Line	:	8430 UNIVERSITY EXEC PARK DR
Second Line	:	SUITE 655
City	:	CHARLOTTE
State	:	NC
Zip	:	28262-1350
Country	:	US
Telephone Number	:	704-596-5553
Fax Number	:	704-596-1556

Authorized Official
Title or Position	:	SERVICES ANALYST
Name	:	MS. PHYLLIS HOWARD
Credential	:
Telephone Number	:	704-596-5553

Provider Enumeration Date	:	04/23/2010
Last Update Date	:	04/02/2014

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Directions to “CONNECTIONS BWB INC ” Practice Location

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