| Clinical Community Solutions Llc | |
|
4312 Waterford Valley Dr Suite 1321 Durham NC 27713-8342 | |
| (585) 975-9216 | |
| Not Available |
| Full Name | Clinical Community Solutions Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 4312 Waterford Valley Dr, Durham, North Carolina |
| Authorized Official Name and Position | Russell Anthony Marino (LPC / CEO) |
| Authorized Official Contact | 5859759216 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Clinical Community Solutions Llc 4312 Waterford Valley Dr Suite 1321 Durham NC 27713-8342 Ph: (585) 975-9216 | Clinical Community Solutions Llc 4312 Waterford Valley Dr Suite 1321 Durham NC 27713-8342 Ph: (585) 975-9216 |
| NPI Number | 1629434451 |
|---|---|
| Provider Enumeration Date | 01/09/2016 |
| Last Update Date | 01/09/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629434451 | NPI | - | NPPES |
| 1538415682 | Other | PERSONAL NPI NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 9058 (North Carolina) | Primary |
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