Provider Demographics
NPI:1609052802
Name:COMPREHENSIVE CONNECTION CASE MANAGEMENT SERVICES
Entity Type:Organization
Organization Name:COMPREHENSIVE CONNECTION CASE MANAGEMENT SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CASE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:FLORENCE
Authorized Official - Middle Name:BENITA
Authorized Official - Last Name:MAXWELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-926-2085
Mailing Address - Street 1:2605 DUNBARTON DR
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78723-2232
Mailing Address - Country:US
Mailing Address - Phone:512-926-2085
Mailing Address - Fax:512-926-1520
Practice Address - Street 1:2605 DUNBARTON DR
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78723-2232
Practice Address - Country:US
Practice Address - Phone:512-926-2085
Practice Address - Fax:512-926-1520
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-17
Last Update Date:2008-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX06255104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty