Provider Demographics
NPI:1215226535
Name:CANCER CARE CONNECTION, INC.
Entity Type:Organization
Organization Name:CANCER CARE CONNECTION, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:JANET
Authorized Official - Middle Name:
Authorized Official - Last Name:TEIXEIRA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:302-654-8554
Mailing Address - Street 1:1 INNOVATION WAY
Mailing Address - Street 2:SUITE 400
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19711-5442
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1 INNOVATION WAY
Practice Address - Street 2:SUITE 400
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19711-5442
Practice Address - Country:US
Practice Address - Phone:302-294-8554
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-07
Last Update Date:2011-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DE17053155770025251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health