Provider Demographics
NPI:1356772339
Name:COMMUNITY CONCEPTS, INC.
Entity type:Organization
Organization Name:COMMUNITY CONCEPTS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:PAULA
Authorized Official - Middle Name:
Authorized Official - Last Name:WELSH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-680-5127
Mailing Address - Street 1:17932 FRALEY BLVD
Mailing Address - Street 2:
Mailing Address - City:DUMFRIES
Mailing Address - State:VA
Mailing Address - Zip Code:22026-2485
Mailing Address - Country:US
Mailing Address - Phone:703-680-5127
Mailing Address - Fax:703-878-1202
Practice Address - Street 1:17932 FRALEY BLVD
Practice Address - Street 2:
Practice Address - City:DUMFRIES
Practice Address - State:VA
Practice Address - Zip Code:22026-2485
Practice Address - Country:US
Practice Address - Phone:703-680-5127
Practice Address - Fax:703-878-1202
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-02
Last Update Date:2022-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA1206-02-006251S00000X
VA1206-02-010251S00000X
VA1206-01-001251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0155693010Medicaid
VA0161912305Medicaid