Provider Demographics
NPI:1336013887
Name:COMMUNITY CARE TEAM MINISTRIES
Entity type:Organization
Organization Name:COMMUNITY CARE TEAM MINISTRIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:COOKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:208-250-9963
Mailing Address - Street 1:PO BOX 745
Mailing Address - Street 2:
Mailing Address - City:MARSING
Mailing Address - State:ID
Mailing Address - Zip Code:83639-0745
Mailing Address - Country:US
Mailing Address - Phone:208-250-9963
Mailing Address - Fax:
Practice Address - Street 1:11115 CHICKEN DINNER RD
Practice Address - Street 2:
Practice Address - City:CALDWELL
Practice Address - State:ID
Practice Address - Zip Code:83607-9741
Practice Address - Country:US
Practice Address - Phone:208-250-9963
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-30
Last Update Date:2025-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes177F00000XOther Service ProvidersLodging