| Community Connections Inc | |
|
801 Pennsylvania Ave Se Ste 201 Washington DC 20003 | |
| (202) 546-1512 | |
| (202) 544-7282 |
| Full Name | Community Connections Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 801 Pennsylvania Ave Se Ste 201, Washington, District Of Columbia |
| Authorized Official Name and Position | Joseph Cullinan (CHIEF ADMINISTRATIVE OFFICER) |
| Authorized Official Contact | 2025287116 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Community Connections Inc 801 Pennsylvania Ave Se Ste 201 Washington DC 20003-2152 Ph: (202) 546-1512 | Community Connections Inc 801 Pennsylvania Ave Se Ste 201 Washington DC 20003 Ph: (202) 546-1512 |
| NPI Number | 1407872575 |
|---|---|
| Provider Enumeration Date | 07/14/2006 |
| Last Update Date | 08/07/2023 |
| Certification Date | 08/07/2023 |
| Medicare PECOS PAC ID | 7315930831 |
|---|---|
| Medicare Enrollment ID | O20040408000217 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407872575 | NPI | - | NPPES |
| 023849100 | Medicaid | DC | |
| 074380100 | Medicaid | DC | |
| 094332900 | Medicaid | DC | |
| 036559700 | Medicaid | DC | |
| 092300100 | Medicaid | MD |
| Provider Name | Mark Rosse |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1588854418 PECOS PAC ID: 3173557089 Enrollment ID: I20050920001364 |
| Provider Name | Jennifer Landrette |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609193671 PECOS PAC ID: 8426343682 Enrollment ID: I20160826001104 |
| Provider Name | Grace V Manglet |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013206655 PECOS PAC ID: 2961650304 Enrollment ID: I20170626000576 |
| Provider Name | Erin E Walczykowski |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316499825 PECOS PAC ID: 7810258431 Enrollment ID: I20180222001881 |
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