Concerted Care Group Dover

Primary specialty

Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X

Legal business name

CONCERTED CARE GROUP DOVER

Practice address

911 S Dupont Hwy
Dover, DE 19901-4468

Phone

(240) 813-9867

NPI assigned

May 24, 2023

Last updated

Aug 20, 2024By the provider in NPPES

Organization subpart

Yes

Parent organization

CCG HOLDCO LLCAs reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Keonna Armstrong

Title

VP of Revenue Cycle Management

Phone

(240) 813-9867

Specialties & licenses 1

Addresses

Tax ID family

Concerted Care Group Dover2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Concerted Care Group Dover LLC

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Dover, DE
  • NPI 1396443990
  NPD tax ID

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1684886400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724112000000",
    "number": "1285326603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3905 NATIONAL DR STE 200",
            "city": "BURTONSVILLE",
            "state": "MD",
            "postal_code": "208666143",
            "telephone_number": "240-813-9867"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "911 S DUPONT HWY",
            "city": "DOVER",
            "state": "DE",
            "postal_code": "199014468",
            "telephone_number": "240-813-9867"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONCERTED CARE GROUP DOVER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CCG HOLDCO LLC",
        "enumeration_date": "2023-05-24",
        "last_updated": "2024-08-20",
        "certification_date": "2024-08-20",
        "status": "A",
        "authorized_official_last_name": "ARMSTRONG",
        "authorized_official_first_name": "KEONNA",
        "authorized_official_title_or_position": "VP OF REVENUE CYCLE MANAGEMENT",
        "authorized_official_telephone_number": "240-813-9867"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Substance Use Disorder Rehabilitation Clinic/Center in Dover, DE
• Providers in Dover, DE by specialty
• Substance Use Disorder Rehabilitation Clinic/Center in Delaware

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.