Provider Demographics
NPI:1073004826
Name:POSITIVE COMMUNITY CONNECTIONS
Entity Type:Organization
Organization Name:POSITIVE COMMUNITY CONNECTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANDREL
Authorized Official - Middle Name:
Authorized Official - Last Name:PINNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-217-2031
Mailing Address - Street 1:1110 NAI RAD LN
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSTON
Mailing Address - State:NC
Mailing Address - Zip Code:27892-7897
Mailing Address - Country:US
Mailing Address - Phone:252-217-2031
Mailing Address - Fax:
Practice Address - Street 1:1110 NAI RAD LN
Practice Address - Street 2:
Practice Address - City:WILLIAMSTON
Practice Address - State:NC
Practice Address - Zip Code:27892-7897
Practice Address - Country:US
Practice Address - Phone:252-217-2031
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-27
Last Update Date:2018-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health