Community Connections and Services, LLC

Primary specialty

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

Legal business name

COMMUNITY CONNECTIONS AND SERVICES, LLC

Practice address

2405 Four Lakes Dr.
Belleville, IL 62220

Phone

(618) 980-3117

NPI assigned

Jul 9, 2021

Organization subpart

No

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

Authorized official

Name

Miss Diedre Foote C Foote

Title

Executive Director

Phone

(618) 980-3117

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1625788800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1625788800000",
    "number": "1821669839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2405 FOUR LAKES DR.",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "62220",
            "telephone_number": "618-980-3117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2405 FOUR LAKES DR.",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "62220",
            "telephone_number": "618-980-3117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY CONNECTIONS AND SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-09",
        "last_updated": "2021-07-09",
        "certification_date": "2021-06-14",
        "status": "A",
        "authorized_official_last_name": "FOOTE",
        "authorized_official_first_name": "DIEDRE FOOTE",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "618-980-3117",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Belleville, IL
• Providers in Belleville, IL by specialty
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2021; 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.