Provider Demographics
NPI:1639516446
Name:CONNECTCARE LLC
Entity Type:Organization
Organization Name:CONNECTCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/SOCIAL WORKER
Authorized Official - Prefix:MS
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:EILEEN
Authorized Official - Last Name:PEREZ
Authorized Official - Suffix:
Authorized Official - Credentials:LBSW, MSW
Authorized Official - Phone:316-409-2822
Mailing Address - Street 1:5319 E PEMBROOK ST
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67220-2626
Mailing Address - Country:US
Mailing Address - Phone:316-409-2822
Mailing Address - Fax:316-942-6012
Practice Address - Street 1:5319 E PEMBROOK ST
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67220-2626
Practice Address - Country:US
Practice Address - Phone:316-409-2822
Practice Address - Fax:316-942-6012
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-03
Last Update Date:2013-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS4937251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management