# COMMUNITY INTEGRATED CARE MANAGEMENT

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Medical Doctor Call
- **Organization subpart:** No

## Provider details

- **NPI number:** 1053525824
- **Authorized official:** MR. MICHAEL MCCONNELL (COO)
- **Authorized official phone:** (703) 955-0544

## Contact information

- **Practice address:** 1615 RHODE ISLAND AVE NE, WASHINGTON, DC 20018-1802
- **Practice address phone:** (202) 269-4511
- **Practice address fax:** (202) 269-3895
- **Mailing address:** 1615 RHODE ISLAND AVE NE, WASHINGTON, DC 20018-1802
- **Mailing address phone:** (202) 269-4511
- **Mailing address fax:** (202) 269-3895

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 171M00000X | Case Manager/Care Coordinator | — | NULL | — |
| 171M00000X | Case Manager/Care Coordinator | — | — | — |
| 261QC1500X | Community Health Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 05/10/2007
- **Last updated:** 02/27/2018