Provider Demographics
NPI:1477178572
Name:COMMUNITY CARE COLLECTIVE
Entity Type:Organization
Organization Name:COMMUNITY CARE COLLECTIVE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HEALTH SERVICES DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:COURTNEY
Authorized Official - Middle Name:
Authorized Official - Last Name:CARAG
Authorized Official - Suffix:
Authorized Official - Credentials:ND, LAC
Authorized Official - Phone:720-663-7194
Mailing Address - Street 1:PO BOX 524
Mailing Address - Street 2:
Mailing Address - City:CRESTONE
Mailing Address - State:CO
Mailing Address - Zip Code:81131-0524
Mailing Address - Country:US
Mailing Address - Phone:720-663-7194
Mailing Address - Fax:
Practice Address - Street 1:909C BROOKVIEW WAY
Practice Address - Street 2:
Practice Address - City:CRESTONE
Practice Address - State:CO
Practice Address - Zip Code:81131
Practice Address - Country:US
Practice Address - Phone:720-663-7194
Practice Address - Fax:720-438-7102
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-15
Last Update Date:2021-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty