Organization
COMMUNITY CARE CASE MANAGEMENT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. VANAVIA NAOMI RICHARDSON MBA (DIRECTOR)
(832) 775-5203
Entity
Organization
Contact information
Practice address
5202 CEDAR ST, BELLAIRE, TX 77401-3915
(832) 775-5203
(832) 775-5204
Mailing address
12407 FOX MEADOW DR, STAFFORD, TX 77477-2285
(832) 775-5203
(832) 775-5204
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
54807
TX
1041C0700X
Clinical Social Worker
55706
TX
251B00000X
Case Management Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
189407301
—
TX
Enumeration date
08/08/2012
Last updated
01/15/2013
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