# COMMUNITY CONNECTIONS FAMILY LIFE CENTER LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1992005805
- **Authorized official:** LETONYA SHAW (DIRECTOR)
- **Authorized official phone:** (336) 253-1268

## Contact information

- **Practice address:** 622 N HAMILTON ST, SUITE 104, HIGH POINT, NC 27262-4076
- **Practice address phone:** (336) 253-1268
- **Mailing address:** PO BOX 47, HIGH POINT, NC 27261-0047
- **Mailing address phone:** (336) 884-7179
- **Mailing address fax:** (336) 884-7189

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 133NN1002X | Nutrition Education Nutritionist | — | NC | — |
| 133V00000X | Registered Dietitian | — | NC | — |
| 208000000X | Pediatrics Physician | — | NULL | — |
| 208000000X | Pediatrics Physician | — | — | — |
| 2083P0901X | Public Health & General Preventive Medicine Physician | — | NULL | Yes |
| 2083P0901X | Public Health & General Preventive Medicine Physician | — | — | Yes |
| 251S00000X | Community/Behavioral Health Agency | — | NULL | — |
| 252Y00000X | Early Intervention Provider Agency | — | NULL | — |

## Other

- **Enumeration date:** 10/26/2010
- **Last updated:** 03/04/2011