Community Coach, Inc.

Primary specialty

Non-emergency Medical Transport (VAN)Taxonomy code 343900000X

Legal business name

COMMUNITY COACH, INC.

Practice address

25 Christy Dr
Brockton, MA 02301-1813

Phone

(781) 760-0650

NPI assigned

May 14, 2015

Organization subpart

No

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

Authorized official

Name

Igor Liberman

Title

Owner

Phone

(508) 586-2222

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Community Coach Inc2 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.

• Community Coach, Inc,

  • Non-emergency Medical Transport (VAN)
  • Brockton, MA
  • NPI 1780837427
  NPD tax ID

Locations

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

{
    "created_epoch": "1431561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1431561600000",
    "number": "1457739047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 CHRISTY DR",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023011813",
            "telephone_number": "781-760-0650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 CHRISTY DR",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023011813",
            "telephone_number": "781-760-0650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY COACH, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-14",
        "last_updated": "2015-05-14",
        "status": "A",
        "authorized_official_last_name": "LIBERMAN",
        "authorized_official_first_name": "IGOR",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "508-586-2222"
    },
    "taxonomies": [
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": "MA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110079596A",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Commonwealth of Massachusetts (Brockton Area Office)
• Commonwealth of Massachusetts-DMH (Southeast Area Office Rehab Option)
• Commonwealth of Massachusetts-DMH (Brockton Multi Service Center Case Mgmt)
• Community Anesthesia LLC
• Community Coach, Inc,
• Community Dentistry, P.C
• Community Psych Healthcare LLC
• Sophonie Compas
• Cheryl Ann Comperchio
• Lakeisha Compte

• Non-emergency Medical Transport (VAN) in Brockton, MA
• Providers in Brockton, MA by specialty
• Non-emergency Medical Transport (VAN) in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2015; 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.