Community Connections Family Resource Center,LLC

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

Legal business name

COMMUNITY CONNECTIONS FAMILY RESOURCE CENTER,LLC

Practice address

9330 W Lincoln Ave Ste A22
Milwaukee, WI 53227-2300

Phone

(414) 484-6247

Fax

(414) 484-6247

NPI assigned

Oct 16, 2019

Organization subpart

No

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

Authorized official

Name

Ms. Sarai Nance, BA IN THEOLOGY

Title

Operator

Phone

(414) 739-7039

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1571184000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1579132800000",
    "number": "1649812199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9330 W LINCOLN AVE # A22",
            "city": "WEST ALLIS",
            "state": "WI",
            "postal_code": "532272300",
            "telephone_number": "414-484-6247",
            "fax_number": "414-494-6247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9330 W LINCOLN AVE STE A22",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532272300",
            "telephone_number": "414-484-6247",
            "fax_number": "414-484-6247"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9330 W Lincoln Ave # A22",
            "address_purpose": "LOCATION",
            "city": "West Allis",
            "state": "WI",
            "postal_code": "532272300",
            "country_code": "US",
            "telephone_number": "414-484-6247",
            "fax_number": "414-494-6247",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "COMMUNITY CONNECTIONS FAMILY RESOURCE CENTER,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-16",
        "last_updated": "2020-01-16",
        "certification_date": "2020-01-16",
        "status": "A",
        "authorized_official_last_name": "NANCE",
        "authorized_official_first_name": "SARAI",
        "authorized_official_title_or_position": "OPERATOR",
        "authorized_official_telephone_number": "414-739-7039",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "BA IN THEOLOGY"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• In Home Supportive Care Agency in Milwaukee, WI
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2020; 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.