COLLABORATIVE COMMUNITY LLC (NPI# 1659993079) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1659993079 |
Entity Type | Organization |
Organization Name | COLLABORATIVE COMMUNITY LLC |
Practice Address |
6000 Filbert Ct Springfield VA 22152-1609 |
Practice Telephone | 2023554327 |
Mailing Telephone | 2023554327 |
Enumeration Date | 2020-05-07 |
Last Update Date | 2020-05-07 |
Authorized Official Name | MR. JAMEL DENNARD KIMBRO (CEO) |
Authorized Official Telephone | 2023554327 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 320900000X | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | Residential Treatment Facilities |
Street Address |
6000 FILBERT CT |
City | SPRINGFIELD |
State | VA |
Zip Code | 22152-1609 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1174140214 | Samantha Maria Puller | Physical Therapist | 8348 Traford Lane Suite 200, Springfield, VA 22152 | 2020-07-05 |
1780102335 | Illuminated Direction | Health Maintenance Organization | 6116 Rolling Road Suite 104, Springfield, VA 22152 | 2017-09-05 |
1023533650 | Megan H Morrow | Dentist | 5803 Rolling Rd Ste 211, Springfield, VA 22152 | 2017-08-04 |
1851815179 | Samantha Apoh | Registered Nurse | 6031 Sweet Oak Ct, Springfield, VA 22152 | 2017-07-28 |
1003366436 | Caitriona Hayes | Psychologist | 8134 Old Keene Mill Road, Suite 101, Springfield, VA 22152 | 2016-10-10 |
1114303450 | Catherine L Kestle | Social Worker | 8136 Old Keene Mill Rd, Suite A-302, Springfield, VA 22152 | 2015-08-10 |
1770999658 | Shehzad Muhammad Sajid | Dentist | 7200 Jillspring Ct, Springfield, VA 22152 | 2014-07-11 |
1063751295 | Rapfhel Adebowale Adenola | Nurse's Aide | 7541 Boston Blvd, Springfield, VA 22152 | 2013-02-07 |
1669742706 | Selamawit Harar | Pharmacist | 8414 Olk Keene Mill Rd, A, Springfield, VA 22152 | 2012-01-06 |
1275822116 | Elizabeth Diane Reed | Social Worker | 8440 Old Keene Mill Rd., Family Counseling of Springfield, Springfield, VA 22152 | 2011-03-31 |
Find all providers in zip 22152 |
Taxonomy Code | 320900000X |
Grouping | Residential Treatment Facilities |
Classification | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities |
A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities. |
Notes: [7/1/2003: new] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1598306904 | Hearo Technologies LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 405 N Jefferson Ave Ste 1063, Springfield, MO 65806-1110 | 2019-10-07 |
1144685785 | Divine Providence Village | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 58 Shelburne Rd, Springfield, PA 19064-2206 | 2015-12-28 |
1912362088 | Divine Providence Village | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 524 Kerr Ln, Springfield, PA 19064-1616 | 2015-12-16 |
1558726620 | Divine Providence Village | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 139 N Hillcrest Rd, Springfield, PA 19064-1441 | 2015-12-16 |
1386029072 | Preferred Family Healthcare, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 2646 W Olive St, Apt A, Springfield, MO 65802-4620 | 2015-07-23 |
1104200096 | The Arc of Union County | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 43 Baltusrol Way, Springfield, NJ 07081-1503 | 2015-07-10 |
1558742940 | Community Action for Independent Living, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 162 Bryant Ave, Springfield, NJ 07081-1615 | 2015-06-11 |
1790177467 | Community Action for Independent Living, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1 Cornell Pkwy, Springfield, NJ 07081-3561 | 2015-03-04 |
1932546702 | Behavioral Learning Center, LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 230 N Belcrest Ave, Suite B, Springfield, MO 65802-6288 | 2013-06-03 |
1134422850 | Abilities First | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1370 E Primrose St, Ste. A, Springfield, MO 65804-4279 | 2010-12-20 |
Find all providers in SPRINGFIELD |
City | SPRINGFIELD |
Zip Code | 22152 |
Please comment or provide details below to improve the information on COLLABORATIVE COMMUNITY LLC.
Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.