Organization · Type 2 NPI

CCJ Adult Care LLC

Adult Care Home Facility · Crouse, NC

NPI number 1063189678 Active

Practice location

1230 Saint Marks Church Rd
Crouse, NC 28033-9600

Call (704) 769-4101 Map

Mailing address

PO Box 74
Bessemer City, NC 28016-0074

Other practice locations

100 W Main Ave Apt 302, Gastonia, NC 28052-4172 · (980) 295-3020

Specialties and licenses

Taxonomy	Code	License
Adult Care Home Facility Primary	311ZA0620X	None listed

Adult Care Home Facility: A custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like environment.

NPI record

NPI: 1063189678
Entity type: Organization (Type 2)
Issued: Aug 23, 2021
Last updated: Aug 23, 2021
Status: Active

Other names

<unavail>
CCJ Adult Care LLC · doing business as
St' Mark Road Care Home · doing business as

Authorized official

Ms. Bernice R Hosch
Administrator/operator
(980) 295-3020

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About NPI 1063189678

CCJ Adult Care LLC's National Provider Identifier is 1063189678, issued on Aug 23, 2021. The primary taxonomy on file is Adult Care Home Facility (311ZA0620X), and the practice location is in Crouse, NC. The record was last updated on Aug 23, 2021.