Provider Demographics
NPI:1477987626
Name:COMMUNITY NETWORK ALLIANCE GROUP
Entity Type:Organization
Organization Name:COMMUNITY NETWORK ALLIANCE GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:MARI
Authorized Official - Middle Name:NANETTE
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-735-2937
Mailing Address - Street 1:509 ABRAHAM CT
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75060-6961
Mailing Address - Country:US
Mailing Address - Phone:469-735-2937
Mailing Address - Fax:972-408-0761
Practice Address - Street 1:509 ABRAHAM CT
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75060-6961
Practice Address - Country:US
Practice Address - Phone:469-735-2937
Practice Address - Fax:972-408-0761
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-23
Last Update Date:2013-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management