Provider Demographics
NPI:1396931036
Name:COMMUNITY PARTNERSHIPS, INC
Entity type:Organization
Organization Name:COMMUNITY PARTNERSHIPS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:BERT
Authorized Official - Middle Name:
Authorized Official - Last Name:FISHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-781-3616
Mailing Address - Street 1:3522 HAWORTH DR
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27609-7217
Mailing Address - Country:US
Mailing Address - Phone:919-781-3616
Mailing Address - Fax:919-782-1485
Practice Address - Street 1:3700 LYCKAN PKWY STE B
Practice Address - Street 2:WESTGATE PLAZA III
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27707-2577
Practice Address - Country:US
Practice Address - Phone:919-781-3616
Practice Address - Fax:919-782-1485
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-17
Last Update Date:2007-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No251B00000XAgenciesCase Management
No251X00000XAgenciesSupports Brokerage
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8300598BMedicaid