Centennial Community Care, LLC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

Legal business name

CENTENNIAL COMMUNITY CARE, LLC

Practice address

545 E Pikes Peak Ave
Colorado Springs, CO 80903-3637

Phone

(940) 597-5382

NPI assigned

Jan 27, 2016

Organization subpart

No

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

Authorized official

Name

Shea Enos

Title

Owner

Phone

(940) 597-5382

Specialties & licenses 2

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1453852800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1453852800000",
    "number": "1659738243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 CEMETERY RD",
            "city": "AURORA",
            "state": "TX",
            "postal_code": "760784503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "545 E PIKES PEAK AVE",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809033637",
            "telephone_number": "940-597-5382"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTENNIAL COMMUNITY CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-27",
        "last_updated": "2016-01-27",
        "status": "A",
        "authorized_official_last_name": "ENOS",
        "authorized_official_first_name": "SHEA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "940-597-5382"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000000000",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Mailin Sue Celestine, NP-C
• Paige Cenicola
• Centennial Medical Group Co LLC
• Centennial State Lab, LLC
• Bianca Centeno, RBT
• Jonathan Centeno
• Maranda L Centeno, MSOT

• Addiction (Substance Use Disorder) Counselor in Colorado Springs, CO
• Providers in Colorado Springs, CO by specialty
• Addiction (Substance Use Disorder) Counselor in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2016; 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.