Provider Demographics
NPI:1932914694
Name:CONNECTED CARE LIVING SYSTEMS LLC
Entity type:Organization
Organization Name:CONNECTED CARE LIVING SYSTEMS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR/LICENSEE
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:CHU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-202-5008
Mailing Address - Street 1:5720 MORNINGSIDE CT
Mailing Address - Street 2:
Mailing Address - City:ROCKLIN
Mailing Address - State:CA
Mailing Address - Zip Code:95677-4515
Mailing Address - Country:US
Mailing Address - Phone:916-259-0559
Mailing Address - Fax:
Practice Address - Street 1:5720 MORNINGSIDE CT
Practice Address - Street 2:
Practice Address - City:ROCKLIN
Practice Address - State:CA
Practice Address - Zip Code:95677-4515
Practice Address - Country:US
Practice Address - Phone:916-259-0559
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-10
Last Update Date:2025-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251X00000XAgenciesSupports Brokerage