Organization
COMMUNITY CARE THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EBONY J JONES COTA/L (DIRECTOR OF OPERATIONS)
(803) 290-1318
Entity
Organization
Contact information
Practice address
1515 HENLEY ST, ORANGEBURG, SC 29115-5031
(803) 290-1318
Mailing address
1515 HENLEY ST, ORANGEBURG, SC 29115-5031
(803) 290-1318
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
—
—
104100000X
Social Worker
—
—
133N00000X
Nutritionist
—
—
183500000X
Pharmacist
—
—
208100000X
Physical Medicine & Rehabilitation Physician
—
—
213E00000X
Podiatrist
—
—
224Z00000X
Occupational Therapy Assistant
—
—
225100000X
Physical Therapist
—
—
225200000X
Physical Therapy Assistant
—
—
225A00000X
Music Therapist
—
—
225X00000X
Occupational Therapist
Primary
—
—
231H00000X
Audiologist
—
—
235Z00000X
Speech-Language Pathologist
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/27/2023
Last updated
05/08/2023
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