Collaborative Community LLC

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

Legal business name

COLLABORATIVE COMMUNITY LLC

Practice address

6000 Filbert CT
Springfield, VA 22152-1609

Phone

(202) 355-4327

NPI assigned

May 7, 2020

Last updated

May 7, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Jamel Dennard KimbroNPI 1831612555

Title

Ceo

Phone

(202) 355-4327

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jamel Dennard Kimbro

  • In Home Supportive Care Agency
  • Greenbelt, MD
  • NPI 1831612555
  NPD Authorized official

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

{
    "created_epoch": "1588809600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1588809600000",
    "number": "1659993079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6000 FILBERT CT",
            "city": "SPRINGFIELD",
            "state": "VA",
            "postal_code": "221521609",
            "telephone_number": "202-355-4327"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6000 FILBERT CT",
            "city": "SPRINGFIELD",
            "state": "VA",
            "postal_code": "221521609",
            "telephone_number": "202-355-4327"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLLABORATIVE COMMUNITY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-07",
        "last_updated": "2020-05-07",
        "certification_date": "2020-05-07",
        "status": "A",
        "authorized_official_last_name": "KIMBRO",
        "authorized_official_first_name": "JAMEL",
        "authorized_official_middle_name": "DENNARD",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "202-355-4327",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Peter K Cocolis Jr., DMD
• Melissa F Coday, LPTA
• Marie Coffelt, DDS
• Lindsey Cogswell
• Jasmin Kilayko Cole, M.D.
• Collins Chiropractic, LLC
• Terry Lynn Collins, MS CCC SLP
• Traci L Colodner, LCSW
• Casey Commerce, RBT
• Commonwealth Mental Health Assoc

• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Springfield, VA
• Providers in Springfield, VA by specialty
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 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.