Community Connection of Minnesota Inc

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

Legal business name

COMMUNITY CONNECTION OF MINNESOTA INC

Practice address

4014 Pitt St
Duluth, MN 55804-1956

Phone

(218) 525-4126

Fax

(218) 525-5862

NPI assigned

May 30, 2006

Organization subpart

No

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

Authorized official

Name

Sharon Mack

Title

Ceo

Phone

(218) 525-4126

Specialties & licenses 1

Addresses

Tax ID family

Community Connection of Minnesota Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Community Connection of MN, Inc.

  • Mental Illness Community Based Residential Treatment Facility
  • Duluth, MN
  • NPI 1023339389
  NPD tax ID

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

{
    "created_epoch": "1148947200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1801843206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4014 PITT STREET",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558041956",
            "telephone_number": "218-525-4126",
            "fax_number": "218-525-5862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4014 PITT ST",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558041956",
            "telephone_number": "218-525-4126",
            "fax_number": "218-525-5862"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY CONNECTION OF MINNESOTA INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-30",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MACK",
        "authorized_official_first_name": "SHARON",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "218-525-4126"
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brittany K Collver, RN
• Sophia Coltvet
• Ella Angelina Comeau
• Common Ground Speech Therapy
• Community Circles, LLC
• Community Connection of MN, Inc.
• Community Diagnostics and Consultation, Inc
• Beth Ann Conley, APRN, CNP
• Christian Conner, RN, CRNA
• James F Conniff, MD

• Adult Care Home Facility in Duluth, MN
• Providers in Duluth, MN by specialty
• Adult Care Home Facility in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.