Organization
COMMUNITY CARE I, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DENISE WOOLLEY CPMSM, CPCS (DIRECTOR, MEDICAL STAFF SERVICES)
(419) 334-6624
Entity
Organization
Contact information
Practice address
8153 MAIN STREET, OLD FORT, OH 44861
(419) 992-4231
(419) 992-4722
Mailing address
715 S TAFT AVE, FREMONT, OH 43420-3200
(419) 334-6624
(419) 334-6602
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0238951
—
OH
Enumeration date
07/10/2006
Last updated
10/20/2010
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