Provider Demographics
NPI:1518112549
Name:COMMUNITY CONNECTIONS, LLC
Entity Type:Organization
Organization Name:COMMUNITY CONNECTIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF ADMINISTRATIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:YOUNG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-358-7400
Mailing Address - Street 1:5907 ELLIS WOODS WAY
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23225-7363
Mailing Address - Country:US
Mailing Address - Phone:804-358-7400
Mailing Address - Fax:804-358-7442
Practice Address - Street 1:5907 ELLIS WOODS WAY
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23225-7363
Practice Address - Country:US
Practice Address - Phone:804-358-7400
Practice Address - Fax:804-358-7442
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-18
Last Update Date:2008-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA752-05-001251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health