Community Care Services,LLC

Primary specialty

Child Intellectual and/or Developmental Disabilities Respite CareTaxonomy code 385HR2060X

Legal business name

COMMUNITY CARE SERVICES,LLC

Practice address

15618 W Port Au Prince LN
Surprise, AZ 85379-6283

Phone

(608) 772-8655

NPI assigned

Oct 5, 2022

Organization subpart

No

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

Authorized official

Name

Oyewale O Oyerinde

Title

President

Phone

(608) 772-8655

Specialties & licenses 6

Addresses

Electronic endpoints 1

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

{
    "created_epoch": "1664928000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1664928000000",
    "number": "1346965100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15618 W PORT AU PRINCE LN",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853796283",
            "telephone_number": "608-772-8655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15618 W PORT AU PRINCE LN",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853796283",
            "telephone_number": "608-772-8655"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15618 W Port Au Prince Ln",
            "address_purpose": "LOCATION",
            "city": "Surprise",
            "state": "AZ",
            "postal_code": "853796283",
            "country_code": "US",
            "telephone_number": "608-772-8655",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "COMMUNITY CARE SERVICES,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-05",
        "last_updated": "2022-10-05",
        "certification_date": "2022-10-04",
        "status": "A",
        "authorized_official_last_name": "OYERINDE",
        "authorized_official_first_name": "OYEWALE",
        "authorized_official_middle_name": "O",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "608-772-8655"
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "385HR2060X",
            "taxonomy_group": "",
            "desc": "Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "385HR2065X",
            "taxonomy_group": "",
            "desc": "Respite Care, Respite Care, Physical Disabilities, Child",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Server",
            "affiliation": "N",
            "address_1": "15618 W Port Au Prince Ln",
            "city": "Surprise",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "853796283",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2022; 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.