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General NPI Number Information
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NPI Number | 1265247845
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Entity Type | Organization
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Legal Business Name | C&C VAN LLC
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Dates
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Enumeration Date | 02/11/2025
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Last Update Date | 05/17/2025
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Provider Practice Location Address
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Address Line | 325 W 3RD AVE STE 101
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City | ESCONDIDO
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State | CA
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Zip | 92025-4140
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Country | US
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Telephone | 949-514-4153
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Fax |
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Provider Business Mailing Address
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Address Line | 428 S FALCON ST
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City | ANAHEIM
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State | CA
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Zip | 92804-2612
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | OCEAN BA VAN
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Credential |
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Telephone | 949-514-4153
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 347C00000X
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Taxonomy Name | Private Vehicle
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 3747P1801X
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Taxonomy Name | Personal Care Attendant
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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