Provider Demographics
NPI:1104643444
Name:COMMUNITY CARE ESSENTIALS
Entity type:Organization
Organization Name:COMMUNITY CARE ESSENTIALS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:HEIGHT-GROSS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-975-6837
Mailing Address - Street 1:PO BOX 2346
Mailing Address - Street 2:
Mailing Address - City:PRINCE FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:20678-2346
Mailing Address - Country:US
Mailing Address - Phone:443-975-6837
Mailing Address - Fax:888-851-5592
Practice Address - Street 1:501 MAIN ST STE 201
Practice Address - Street 2:
Practice Address - City:PRINCE FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:20678-6111
Practice Address - Country:US
Practice Address - Phone:443-975-6837
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-25
Last Update Date:2024-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies