Commonwealth Community Recovery Division Inc

Primary specialty

TaxiTaxonomy code 344600000X

License

S49769293 Issued in MA

Legal business name

COMMONWEALTH COMMUNITY RECOVERY DIVISION INC

Doing business as

ccrd llc

Practice address

79 Thompson St
Springfield, MA 01109-3921

Phone

(888) 680-4667

Fax

(888) 726-8386

NPI assigned

Apr 10, 2017

Organization subpart

No

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

Authorized official

Name

Mr. Paul Jones

Title

President

Phone

(888) 680-4667

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• ccrd llc Doing business as

Tax ID family

CCRD 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.

• Commonwealth Cummunity Recovery Division

  dba CCRD Inc.

  • Non-emergency Medical Transport (VAN)
  • Springfield, MA
  • NPI 1275928459
  NPD tax ID

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

{
    "created_epoch": "1491782400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1491782400000",
    "number": "1558894261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "79 THOMPSON ST",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011093921",
            "telephone_number": "888-680-4667",
            "fax_number": "888-726-8386"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "79 THOMPSON ST",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011093921",
            "telephone_number": "888-680-4667",
            "fax_number": "888-726-8386"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMONWEALTH COMMUNITY RECOVERY DIVISION INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-10",
        "last_updated": "2017-04-10",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "PAUL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "888-680-4667",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "344600000X",
            "taxonomy_group": "",
            "desc": "Taxi",
            "state": "MA",
            "license": "S49769293",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "23",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ccrd llc",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Diana Colucci, NP
• Mariana Colussi-Pelaez, MD
• Jaden William Colwell
• Commonpure LLC
• Commonwealth Clinical Alliance
• Commonwealth Cummunity Recovery Division (CCRD Inc.)
• Commonwealth Eyecare Professionals, LLC
• Commonwealth of Massachusets (DDS Springfield/Westfield Area Office)
• Commonwealthcare Alliance (No)
• Community Action Network, Inc.

• Taxi in Springfield, MA
• Providers in Springfield, MA by specialty
• Taxi in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2017; 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.