MEDICARE: CARE COORDINATION SOLUTIONS, 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	251B00000X	Case Management Agency

General Provider Information

NPI Number	:	1548796337
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CARE COORDINATION SOLUTIONS, LLC

Provider Business Mailing Address
First Line	:	3034 KINGSBRIDGE AVE
Second Line	:	3AN
City	:	BRONX
State	:	NY
Zip	:	10463-5125
Country	:	US
Telephone Number	:	929-245-3726
Fax Number	:

Provider Business Practice Location Address
First Line	:	3034 KINGSBRIDGE AVE
Second Line	:	3AN
City	:	BRONX
State	:	NY
Zip	:	10463-5125
Country	:	US
Telephone Number	:	929-245-3726
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	MISS ROSEMARY CABRERA
Credential	:	MSW
Telephone Number	:	929-245-3726

Provider Enumeration Date	:	05/11/2017
Last Update Date	:	05/11/2017

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