Provider Demographics
NPI:1154856474
Name:COMMUNITY CARE PARTNERS, LLC
Entity Type:Organization
Organization Name:COMMUNITY CARE PARTNERS, LLC
Other - Org Name:IN MOTION MEDICAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:KELLI
Authorized Official - Middle Name:L
Authorized Official - Last Name:CASADY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-462-2950
Mailing Address - Street 1:12035 N SAGUARO BLVD
Mailing Address - Street 2:STE 203
Mailing Address - City:FOUNTAIN HILLS
Mailing Address - State:AZ
Mailing Address - Zip Code:85268-4647
Mailing Address - Country:US
Mailing Address - Phone:480-462-2950
Mailing Address - Fax:
Practice Address - Street 1:12035 N SAGUARO BLVD
Practice Address - Street 2:STE 203
Practice Address - City:FOUNTAIN HILLS
Practice Address - State:AZ
Practice Address - Zip Code:85268
Practice Address - Country:US
Practice Address - Phone:623-256-3986
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-24
Last Update Date:2018-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult MedicineGroup - Multi-Specialty
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Multi-Specialty