Provider Demographics
NPI:1174669675
Name:COMMUNITY CONNECTIONS, INC.
Entity Type:Organization
Organization Name:COMMUNITY CONNECTIONS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT OF OPERATIONS
Authorized Official - Prefix:MS
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-362-1140
Mailing Address - Street 1:127 WHITES PATH
Mailing Address - Street 2:
Mailing Address - City:S YARMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02664-1217
Mailing Address - Country:US
Mailing Address - Phone:508-362-1140
Mailing Address - Fax:508-362-9198
Practice Address - Street 1:127 WHITES PATH
Practice Address - Street 2:
Practice Address - City:S YARMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02664-1217
Practice Address - Country:US
Practice Address - Phone:508-362-1140
Practice Address - Fax:508-362-9198
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1301080Medicaid
MA1311972Medicaid
MA1305506Medicaid
MA1311336Medicaid
MA1319477Medicaid
MA1305549Medicaid
MA1305778Medicaid
MA1311328Medicaid
MA1312235Medicaid