Provider Demographics
NPI:1457613200
Name:COMMUNITY CARE PARTNERS INC
Entity Type:Organization
Organization Name:COMMUNITY CARE PARTNERS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:L
Authorized Official - Last Name:BLICKER
Authorized Official - Suffix:
Authorized Official - Credentials:MA, CCC-SLPD,BRS-S
Authorized Official - Phone:305-467-9682
Mailing Address - Street 1:10645 NW 69TH PL
Mailing Address - Street 2:
Mailing Address - City:PARKLAND
Mailing Address - State:FL
Mailing Address - Zip Code:33076-2969
Mailing Address - Country:US
Mailing Address - Phone:305-467-9682
Mailing Address - Fax:
Practice Address - Street 1:10645 NW 69TH PL
Practice Address - Street 2:
Practice Address - City:PARKLAND
Practice Address - State:FL
Practice Address - Zip Code:33076-2969
Practice Address - Country:US
Practice Address - Phone:305-467-9682
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-07
Last Update Date:2012-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty