Provider Demographics
NPI:1275675571
Name:CONNECTICUT COMMUNITY CARE INC
Entity Type:Organization
Organization Name:CONNECTICUT COMMUNITY CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:G
Authorized Official - Last Name:CONSORTE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:860-589-6226
Mailing Address - Street 1:43 ENTERPRISE DRIVE
Mailing Address - Street 2:
Mailing Address - City:BRISTOL
Mailing Address - State:CT
Mailing Address - Zip Code:06010-7472
Mailing Address - Country:US
Mailing Address - Phone:860-589-6226
Mailing Address - Fax:860-585-0858
Practice Address - Street 1:43 ENTERPRISE DRIVE
Practice Address - Street 2:
Practice Address - City:BRISTOL
Practice Address - State:CT
Practice Address - Zip Code:06010-7472
Practice Address - Country:US
Practice Address - Phone:860-589-6226
Practice Address - Fax:860-585-0858
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management