Provider Demographics
| NPI: | 1033718606 |
|---|---|
| Name: | COMMUNITY CONNECTIONS, INC. |
| Entity type: | Organization |
| Organization Name: | COMMUNITY CONNECTIONS, INC. |
| Other - Org Name: | <UNAVAIL> |
| Other - Org Type: | |
| Authorized Official - Title/Position: | EXECUTIVE DIRECTOR |
| Authorized Official - Prefix: | |
| Authorized Official - First Name: | TANDRA |
| Authorized Official - Middle Name: | |
| Authorized Official - Last Name: | THOMPSON |
| Authorized Official - Suffix: | |
| Authorized Official - Credentials: | |
| Authorized Official - Phone: | 907-225-7825 |
| Mailing Address - Street 1: | 721 STEDMAN ST |
| Mailing Address - Street 2: | |
| Mailing Address - City: | KETCHIKAN |
| Mailing Address - State: | AK |
| Mailing Address - Zip Code: | 99901-6632 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 907-225-7825 |
| Mailing Address - Fax: | 907-225-1541 |
| Practice Address - Street 1: | 1800 CRAIG KLAWOCK HWY STE 241 |
| Practice Address - Street 2: | |
| Practice Address - City: | CRAIG |
| Practice Address - State: | AK |
| Practice Address - Zip Code: | 99921-0678 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 907-826-3891 |
| Practice Address - Fax: | 907-826-3892 |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | No |
| Parent Organization LBN: | |
| Parent Organization TIN: | |
| Enumeration Date: | 2020-10-23 |
| Last Update Date: | 2025-07-18 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization |
|---|---|---|---|---|
| Yes | 251S00000X | Agencies | Community/Behavioral Health |
Provider Identifiers
| State | Identifier ID | ID Type | Issuer |
|---|---|---|---|
| AK | 1712659 | Medicaid |