OrganizationActive
Complete Care Coordination Agency
NPI 1114474459 · Health Maintenance Organization · Philadelphia, PA
Provider details
- NPI number
- 1114474459
- Entity type
- Organization
- Primary specialty
- Health Maintenance OrganizationManaged Care Organizations
- Parent organization
- Complete Care Coordination Agency
- Organization subpart
- Yes
- Authorized official
- Johanne Mesidor-Dorsainvil, Chief Executive Officer(215) 668-5769
Specialties & taxonomies
Managed Care Organizations
Practice location
6324 Shelbourne St
Philadelphia, PA 19111-5615
Phone: (215) 668-5769
Approximate (ZIP-level) locationGet directions
Mailing address
6324 Shelbourne St
Philadelphia, PA 19111-5615
Registry dates
- Enumerated
- 2016-09-03
- Last updated
- 2016-09-03
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.