Provider Demographics
NPI:1932782950
Name:CONNECTED CARE HEALTH SOLUTIONS
Entity Type:Organization
Organization Name:CONNECTED CARE HEALTH SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AGENCY DIRECTOR/ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:KENYA
Authorized Official - Middle Name:
Authorized Official - Last Name:GOMEZ
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:919-650-4601
Mailing Address - Street 1:1003 MULFORD CT UNIT 159
Mailing Address - Street 2:
Mailing Address - City:KNIGHTDALE
Mailing Address - State:NC
Mailing Address - Zip Code:27545-0196
Mailing Address - Country:US
Mailing Address - Phone:919-650-4601
Mailing Address - Fax:919-373-8156
Practice Address - Street 1:101 FOREST DR STE B
Practice Address - Street 2:
Practice Address - City:KNIGHTDALE
Practice Address - State:NC
Practice Address - Zip Code:27545-9603
Practice Address - Country:US
Practice Address - Phone:919-650-4601
Practice Address - Fax:919-373-8156
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-29
Last Update Date:2021-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care