Provider Demographics
NPI:1518342872
Name:COMMUNITY CARE MANAGEMENT LLC
Entity Type:Organization
Organization Name:COMMUNITY CARE MANAGEMENT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:PHIL
Authorized Official - Middle Name:
Authorized Official - Last Name:OPATZ
Authorized Official - Suffix:
Authorized Official - Credentials:MPH
Authorized Official - Phone:212-290-6467
Mailing Address - Street 1:1250 BROADWAY
Mailing Address - Street 2:22ND FL.
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10001-3701
Mailing Address - Country:US
Mailing Address - Phone:212-465-2741
Mailing Address - Fax:212-290-3532
Practice Address - Street 1:1250 BROADWAY
Practice Address - Street 2:22ND FL.
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-3701
Practice Address - Country:US
Practice Address - Phone:212-465-2741
Practice Address - Fax:212-290-3532
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-28
Last Update Date:2015-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management