Provider Demographics
NPI:1275105454
Name:HEALTH CARE CONNECTIONS SERVICES LLC
Entity Type:Organization
Organization Name:HEALTH CARE CONNECTIONS SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:COURTNEY
Authorized Official - Middle Name:
Authorized Official - Last Name:GRAVES
Authorized Official - Suffix:
Authorized Official - Credentials:DR
Authorized Official - Phone:314-596-2760
Mailing Address - Street 1:2075 AQUEDUCT DR
Mailing Address - Street 2:
Mailing Address - City:FLORISSANT
Mailing Address - State:MO
Mailing Address - Zip Code:63033-2861
Mailing Address - Country:US
Mailing Address - Phone:314-596-2760
Mailing Address - Fax:
Practice Address - Street 1:2075 AQUEDUCT DR
Practice Address - Street 2:
Practice Address - City:FLORISSANT
Practice Address - State:MO
Practice Address - Zip Code:63033-2861
Practice Address - Country:US
Practice Address - Phone:314-596-2760
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-15
Last Update Date:2021-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
No251B00000XAgenciesCase Management
No251E00000XAgenciesHome Health
No251S00000XAgenciesCommunity/Behavioral Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
No261QM1000XAmbulatory Health Care FacilitiesClinic/CenterMigrant HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO1295001394Medicaid