Community Coalition Alliance

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

COMMUNITY COALITION ALLIANCE

Practice address

516 S 10TH St
Suite 211
Fernandina, FL 32034-3530

Phone

(904) 277-3699

Fax

(904) 277-7043

NPI assigned

Aug 15, 2013

Organization subpart

No

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

Authorized official

Name

Debi Macintyre

Title

Board Chair

Phone

(352) 408-2009

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1376524800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1376524800000",
    "number": "1942633755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "516 S 10TH ST",
            "address_2": "SUITE 211",
            "city": "FERNANDINA",
            "state": "FL",
            "postal_code": "320343530",
            "telephone_number": "904-277-3699",
            "fax_number": "904-277-7043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "516 S 10TH ST",
            "address_2": "SUITE 211",
            "city": "FERNANDINA",
            "state": "FL",
            "postal_code": "320343530",
            "telephone_number": "904-277-3699",
            "fax_number": "904-277-7043"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY COALITION ALLIANCE",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-08-15",
        "last_updated": "2013-08-15",
        "status": "A",
        "authorized_official_last_name": "MACINTYRE",
        "authorized_official_first_name": "DEBI",
        "authorized_official_title_or_position": "BOARD CHAIR",
        "authorized_official_telephone_number": "352-408-2009"
    },
    "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 Fernandina, FL
• Providers in Fernandina, FL by specialty
• Community/Behavioral Health Agency in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2013; 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.