Provider Demographics
NPI:1699397786
Name:CARE CONNECT BEHAVIORAL HEALTH, LLC
Entity Type:Organization
Organization Name:CARE CONNECT BEHAVIORAL HEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-237-6257
Mailing Address - Street 1:3520 HIGH ST STE 100
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:VA
Mailing Address - Zip Code:23707-3126
Mailing Address - Country:US
Mailing Address - Phone:757-237-6257
Mailing Address - Fax:757-962-9368
Practice Address - Street 1:3520 HIGH ST STE 100
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:VA
Practice Address - Zip Code:23707-3126
Practice Address - Country:US
Practice Address - Phone:757-237-6257
Practice Address - Fax:757-962-9368
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-12
Last Update Date:2020-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QA0401XAllopathic & Osteopathic PhysiciansFamily MedicineAddiction MedicineGroup - Multi-Specialty