Organization
COMMUNITY CLINIC, INC.
Active
Parent organization
COMMUNITY CLINIC INC.
Other names
CCI Health Services
Organization subpart
Yes
Provider details
NPI number
Legal business name
COMMUNITY CLINIC INC.
Authorized official
SONYA J BRUTON (CEO)
(240) 839-5107
Entity
Organization
Contact information
Practice address
2730 UNIVERSITY BLVD WEST, #LL10, WHEATON, MD 20902
(301) 933-6680
(301) 495-0318
Mailing address
8665 GEORGIA AVE, SILVER SPRING, MD 20910-3405
(301) 340-7525
(301) 495-0318
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
—
—
2251P0200X
Pediatric Physical Therapist
—
—
251V00000X
Voluntary or Charitable Agency
—
—
261QC1500X
Community Health Clinic/Center
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
053601
MEDICARE
MD
05
—
130061000
—
MD
Enumeration date
04/23/2021
Last updated
12/13/2024
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