Provider Demographics
NPI:1427202647
Name:CCA COMPANIES LLC
Entity Type:Organization
Organization Name:CCA COMPANIES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:LEANNA
Authorized Official - Middle Name:E
Authorized Official - Last Name:MANUEL
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:937-431-3870
Mailing Address - Street 1:810 ORCHARD LN STE 102
Mailing Address - Street 2:
Mailing Address - City:BEAVERCREEK TOWNSHIP
Mailing Address - State:OH
Mailing Address - Zip Code:45434-7221
Mailing Address - Country:US
Mailing Address - Phone:937-431-3870
Mailing Address - Fax:937-431-3871
Practice Address - Street 1:810 ORCHARD LN STE 102
Practice Address - Street 2:
Practice Address - City:BEAVERCREEK TOWNSHIP
Practice Address - State:OH
Practice Address - Zip Code:45434-7221
Practice Address - Country:US
Practice Address - Phone:937-431-3870
Practice Address - Fax:937-431-3871
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-14
Last Update Date:2012-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty