Provider Demographics
NPI:1780552794
Name:CAMPUS CARE COLLECTIVE LLC
Entity type:Organization
Organization Name:CAMPUS CARE COLLECTIVE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:VICTOR
Authorized Official - Middle Name:A
Authorized Official - Last Name:MENSAH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:848-218-6537
Mailing Address - Street 1:131 BROOME ST APT 9B
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10002-4056
Mailing Address - Country:US
Mailing Address - Phone:848-218-6537
Mailing Address - Fax:
Practice Address - Street 1:131 BROOME ST APT 9B
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10002-4056
Practice Address - Country:US
Practice Address - Phone:848-218-6537
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-10-29
Last Update Date:2025-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty