Provider Demographics
NPI:1497124960
Name:COMMUNITY CONCEPTS, INC.
Entity Type:Organization
Organization Name:COMMUNITY CONCEPTS, INC.
Other - Org Name:HOME 9
Other - Org Type:Other Name
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:BETTY
Authorized Official - Middle Name:
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-398-8885
Mailing Address - Street 1:6699 TRI WAY DR
Mailing Address - Street 2:
Mailing Address - City:MASON
Mailing Address - State:OH
Mailing Address - Zip Code:45040-2604
Mailing Address - Country:US
Mailing Address - Phone:513-398-8885
Mailing Address - Fax:513-398-8181
Practice Address - Street 1:6699 TRI WAY DR
Practice Address - Street 2:
Practice Address - City:MASON
Practice Address - State:OH
Practice Address - Zip Code:45040-2604
Practice Address - Country:US
Practice Address - Phone:513-398-8885
Practice Address - Fax:513-398-8181
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:EBKK CORP.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-09-15
Last Update Date:2015-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes315P00000XNursing & Custodial Care FacilitiesIntermediate Care Facility, Intellectual Disabilities