Provider Demographics
NPI:1821054917
Name:COMMUNITY CHALLENGE, INC.
Entity Type:Organization
Organization Name:COMMUNITY CHALLENGE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:M
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:OCPS II
Authorized Official - Phone:440-331-3838
Mailing Address - Street 1:20525 CENTER RIDGE RD
Mailing Address - Street 2:SUITE 518
Mailing Address - City:ROCKY RIVER
Mailing Address - State:OH
Mailing Address - Zip Code:44116-3437
Mailing Address - Country:US
Mailing Address - Phone:440-331-3838
Mailing Address - Fax:440-331-5655
Practice Address - Street 1:20525 CENTER RIDGE RD
Practice Address - Street 2:SUITE 518
Practice Address - City:ROCKY RIVER
Practice Address - State:OH
Practice Address - Zip Code:44116-3437
Practice Address - Country:US
Practice Address - Phone:440-331-3838
Practice Address - Fax:440-331-5655
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH02426OtherUPI