Provider Demographics
NPI:1649045196
Name:COMPETENCY CARE CONNECT LLC
Entity type:Organization
Organization Name:COMPETENCY CARE CONNECT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:KIANA
Authorized Official - Middle Name:
Authorized Official - Last Name:EVANS-RIVERA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-250-2904
Mailing Address - Street 1:1806 HAYWARD AVE STE A1
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23320-2200
Mailing Address - Country:US
Mailing Address - Phone:757-250-2904
Mailing Address - Fax:
Practice Address - Street 1:1806 HAYWARD AVE STE A1
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23320-2200
Practice Address - Country:US
Practice Address - Phone:757-250-2904
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-15
Last Update Date:2023-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health