Provider Demographics
NPI: | 1275774739 |
---|---|
Name: | COMMUNITY CONCEPTS, INC. |
Entity type: | Organization |
Organization Name: | COMMUNITY CONCEPTS, INC. |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | DIRECTOR BEHAVIORAL HEALTH |
Authorized Official - Prefix: | |
Authorized Official - First Name: | JESSICA |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | LEBLANC |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 207-240-7701 |
Mailing Address - Street 1: | 150 CONGRESS ST |
Mailing Address - Street 2: | |
Mailing Address - City: | RUMFORD |
Mailing Address - State: | ME |
Mailing Address - Zip Code: | 04276-2035 |
Mailing Address - Country: | US |
Mailing Address - Phone: | |
Mailing Address - Fax: | |
Practice Address - Street 1: | 150 CONGRESS ST |
Practice Address - Street 2: | |
Practice Address - City: | RUMFORD |
Practice Address - State: | ME |
Practice Address - Zip Code: | 04276-2035 |
Practice Address - Country: | US |
Practice Address - Phone: | 207-364-3549 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2009-03-13 |
Last Update Date: | 2024-10-01 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 320800000X | Residential Treatment Facilities | Community Based Residential Treatment Facility, Mental Illness |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
ME | 432619000 | Medicaid |