Provider Demographics
NPI:1194320739
Name:COMMUNITY CONNECTIONS NORTHEAST OHIO
Entity type:Organization
Organization Name:COMMUNITY CONNECTIONS NORTHEAST OHIO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ROBIN
Authorized Official - Middle Name:R
Authorized Official - Last Name:BACOLA
Authorized Official - Suffix:
Authorized Official - Credentials:MS ED
Authorized Official - Phone:234-251-2626
Mailing Address - Street 1:1647 BRITTAIN RD
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44310-2701
Mailing Address - Country:US
Mailing Address - Phone:234-251-2626
Mailing Address - Fax:
Practice Address - Street 1:1647 BRITTAIN RD
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44310-2701
Practice Address - Country:US
Practice Address - Phone:234-251-2626
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-02
Last Update Date:2020-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services