Organization
COMPLETE CARE COORDINATION AGENCY
Active
Parent organization
COMPLETE CARE COORDINATION AGENCY
Organization subpart
Yes
Provider details
NPI number
Legal business name
COMPLETE CARE COORDINATION AGENCY
Authorized official
MRS. JOHANNE MESIDOR-DORSAINVIL (CHIEF EXECUTIVE OFFICER)
(215) 668-5769
Entity
Organization
Contact information
Practice address
6324 SHELBOURNE ST, PHILADELPHIA, PA 19111-5615
(215) 668-5769
Mailing address
6324 SHELBOURNE ST, PHILADELPHIA, PA 19111-5615
(215) 668-5769
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
—
—
Other
Enumeration date
09/03/2016
Last updated
09/03/2016
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