Community Clinical Services LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

COMMUNITY CLINICAL SERVICES LLC

Practice address

8401 University Exec Park Dr
Suite 127
Charlotte, NC 28262-3386

Phone

(404) 838-1550

NPI assigned

Jul 16, 2012

Organization subpart

No

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

Authorized official

Name

Adrian Verwayne

Title

Owner

Phone

(678) 524-2195

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1342396800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1342396800000",
    "number": "1740535830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "882 MARTIN LUTHER KING JR DR SW STE B",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303143606",
            "fax_number": "866-502-0926"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8401 UNIVERSITY EXEC PARK DR",
            "address_2": "SUITE 127",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282623386",
            "telephone_number": "404-838-1550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY CLINICAL SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-16",
        "last_updated": "2012-07-16",
        "status": "A",
        "authorized_official_last_name": "VERWAYNE",
        "authorized_official_first_name": "ADRIAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "678-524-2195"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Community/Behavioral Health Agency in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Community/Behavioral Health Agency in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2012; 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.