Organization
COMMUNITY CARE NETWORK
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KARINA POLEN-DAVIS (EXECUTIVE DIRECTOR)
(334) 269-6251
Entity
Organization
Contact information
Practice address
1629 FOREST AVE, MONTGOMERY, AL 36106-1541
(334) 269-6251
(334) 269-6253
Mailing address
1629 FOREST AVE, MONTGOMERY, AL 36106-1541
(334) 269-6251
(334) 269-6253
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
L5127
AL
Other
Enumeration date
03/15/2007
Last updated
08/22/2020
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