| Community Care Center Inc | |
|
110 S Queen St 110 South Queen Street Suite 118 Kinston NC 28501-4975 | |
| (252) 208-1928 | |
| (252) 559-2055 |
| Full Name | Community Care Center Inc |
|---|---|
| Speciality | Health Maintenance Organization |
| Location | 110 S Queen St, Kinston, North Carolina |
| Authorized Official Name and Position | Esau Arnold Mcmorris (PRESIDENT) |
| Authorized Official Contact | 2522081928 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Community Care Center Inc Po Box 3392 Kinston NC 28502-3392 Ph: (252) 208-1928 | Community Care Center Inc 110 S Queen St 110 South Queen Street Suite 118 Kinston NC 28501-4975 Ph: (252) 208-1928 |
| NPI Number | 1093712754 |
|---|---|
| Provider Enumeration Date | 07/07/2005 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093712754 | NPI | - | NPPES |
| 6111780 | Medicaid | NC | |
| 8700395 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 101YA00000X (North Carolina) | Primary |
| 302R00000X | Health Maintenance Organization | 8700395 (North Carolina) | Primary |
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