MEDICARE: CHRIST CENTERED COMMUNITY LLC

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	101YP2500X	Professional Counselor

General Provider Information

NPI Number	:	1528896487
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHRIST CENTERED COMMUNITY LLC

Provider Business Mailing Address
First Line	:	31 RANDALL RD
Second Line	:
City	:	MATTAPOISETT
State	:	MA
Zip	:	02739-1647
Country	:	US
Telephone Number	:	508-287-0077
Fax Number	:

Provider Business Practice Location Address
First Line	:	74 FAUNCE CORNER RD
Second Line	:
City	:	DARTMOUTH
State	:	MA
Zip	:	02747-1209
Country	:	US
Telephone Number	:	508-287-0077
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	LEONIA ALVES
Credential	:
Telephone Number	:	508-287-0077

Provider Enumeration Date	:	07/23/2024
Last Update Date	:	07/23/2024

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Directions to “CHRIST CENTERED COMMUNITY LLC ” Practice Location

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