Community Connections Family Life Center, LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

COMMUNITY CONNECTIONS FAMILY LIFE CENTER, LLC

Practice address

9635 Southern Pine Blvd
Suite 112
Charlotte, NC 28273-5558

Phone

(336) 884-1519

Fax

(336) 884-1519

NPI assigned

May 13, 2009

Organization subpart

No

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

Authorized official

Name

Mrs. Letonya W Shaw

Title

Director

Phone

(336) 884-1519

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1242172800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1243468800000",
    "number": "1790919181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9238",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274290238",
            "telephone_number": "336-884-1519",
            "fax_number": "336-884-1519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9635 SOUTHERN PINE BLVD",
            "address_2": "SUITE 112",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282735558",
            "telephone_number": "336-884-1519",
            "fax_number": "336-884-1519"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY CONNECTIONS FAMILY LIFE CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-13",
        "last_updated": "2009-05-28",
        "status": "A",
        "authorized_official_last_name": "SHAW",
        "authorized_official_first_name": "LETONYA",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "336-884-1519",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2009; 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.