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COMMUNITY CARE CENTER INC

Addiction Substance Use Disorder

Kinston, North Carolina

Provider NPI: 1093712754

Organization Information:
Organization Name:  COMMUNITY CARE CENTER INC
Organization is not Subpart
Authorized Official:  ESAU ARNOLD MCMORRIS  PRESIDENT  252-2081928

Practice Location:
110 S QUEEN ST 110 SOUTH QUEEN STREET SUITE 118 KINSTON, NC 28501 US
Tel: 252-208-1928  Fax: 252-559-2055

Business Mailing Address:
PO BOX 3392  KINSTON, NC 28502 US
Tel: 252-208-1928  Fax: 252-559-2055

Entity Type: Organization

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
X101YA0400XBehavioral Health & Social Service Providers
Counselor
Addiction (Substance Use Disorder)
NC101YA00000X
X302R00000XManaged Care Organizations
Health Maintenance Organization
NC8700395

Other Provider Identifiers:

IssuerNumberStateType
6111780NC05
8700395NY05
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin







ADDICTION JOBS NC - Page 1



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