Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Diabetes Educator |
163WD0400X | |||
Case Management |
251B00000X |
| NPI Number | 1891246195 |
||||
| LBN Legal business name | COMMUNITY CARE SOLUTIONS | ||||
| Authorized official | DANA EIDSON - (EXECUTIVE DIRECTOR) | ||||
| Entity | Organization | ||||
| Organization subpart 1 | No | ||||
| Enumeration date | 10/21/2016 | ||||
| Last updated | 04/18/2019 - About 7 years ago | ||||
| Identifiers |
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