Organization · NPI-2

Community Care Services,llc

Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child · Surprise, AZ

NPI number1346965100
StatusActive
Last updated in NPPESOct 5, 2022

Details

NPI
1346965100
Entity type
Organization (NPI-2)
Legal business name
Community Care Services,llc
Organization subpart
No
Enumeration date
Oct 5, 2022
Certification date
Oct 4, 2022
Last updated
Oct 5, 2022

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
385HR2060X Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child––Yes
251C00000X Day Training, Developmentally Disabled Services––
251E00000X Home Health––
253Z00000X In Home Supportive Care––
320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities––
385HR2065X Respite Care, Respite Care, Physical Disabilities, Child––

Practice location

15618 W Port Au Prince Ln
Surprise, AZ 85379-6283

Phone 608-772-8655

Mailing address

15618 W Port Au Prince Ln
Surprise, AZ 85379-6283

Phone 608-772-8655

Other practice locations

15618 W Port Au Prince Ln
Surprise, AZ 85379-6283

Phone 608-772-8655

Authorized official

Oyewale O Oyerinde
President
6087728655

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