Provider Demographics
NPI:1912787672
Name:A CARE COORDINATION AGENCY
Entity Type:Organization
Organization Name:A CARE COORDINATION AGENCY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LEONARD
Authorized Official - Middle Name:EDWARD III
Authorized Official - Last Name:CREER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-770-1727
Mailing Address - Street 1:18064 WIKA RD STE 201
Mailing Address - Street 2:
Mailing Address - City:APPLE VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92307-2182
Mailing Address - Country:US
Mailing Address - Phone:323-770-1727
Mailing Address - Fax:
Practice Address - Street 1:18064 WIKA RD STE 201
Practice Address - Street 2:
Practice Address - City:APPLE VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92307-2182
Practice Address - Country:US
Practice Address - Phone:323-770-1727
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-02
Last Update Date:2023-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management