Provider Demographics
NPI:1043374804
Name:COMBINED COMMUNITY ACTION INC
Entity Type:Organization
Organization Name:COMBINED COMMUNITY ACTION INC
Other - Org Name:COMBINED COMMUNITY ACTION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KELLY
Authorized Official - Middle Name:JO
Authorized Official - Last Name:FRANKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:979-540-2999
Mailing Address - Street 1:165 W AUSTIN
Mailing Address - Street 2:
Mailing Address - City:GIDDINGS
Mailing Address - State:TX
Mailing Address - Zip Code:78957
Mailing Address - Country:US
Mailing Address - Phone:979-540-2980
Mailing Address - Fax:979-542-9565
Practice Address - Street 1:165 W AUSTIN
Practice Address - Street 2:
Practice Address - City:GIDDINGS
Practice Address - State:TX
Practice Address - Zip Code:78957
Practice Address - Country:US
Practice Address - Phone:979-540-2980
Practice Address - Fax:979-542-9565
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-19
Last Update Date:2018-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX23352251B00000X
TX332U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
No332U00000XSuppliersHome Delivered Meals
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX179491902Medicaid