| Community Care Service Llc | |
|
5842 Fayetteville Rd Ste 101 Durham NC 27713-6294 | |
| (919) 544-3907 | |
| Not Available |
| Full Name | Community Care Service Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 5842 Fayetteville Rd Ste 101, Durham, North Carolina |
| Authorized Official Name and Position | Mynekia Perry (MEMBER) |
| Authorized Official Contact | 9195443907 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Community Care Service Llc Po Box 13368 Durham NC 27709-3368 Ph: (919) 544-3907 | Community Care Service Llc 5842 Fayetteville Rd Ste 101 Durham NC 27713-6294 Ph: (919) 544-3907 |
| NPI Number | 1720277973 |
|---|---|
| Provider Enumeration Date | 10/23/2007 |
| Last Update Date | 07/21/2022 |
| Medicare PECOS PAC ID | 6608045745 |
|---|---|
| Medicare Enrollment ID | O20110808000242 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720277973 | NPI | - | NPPES |
| Provider Name | Patrice Schmitz |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1205860699 PECOS PAC ID: 9739332875 Enrollment ID: I20130123000366 |
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