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General NPI Number Information
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NPI Number | 1275457434
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Entity Type | Organization
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Legal Business Name | CC CARES LLC
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Dates
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Enumeration Date | 08/08/2026
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Last Update Date | 08/08/2026
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Provider Practice Location Address
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Address Line | 43 RIVES RD # B-11
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City | PETERSBURG
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State | VA
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Zip | 23805-9255
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Country | US
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Telephone | 804-721-9929
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Fax |
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Provider Business Mailing Address
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Address Line | 19105 SPRIGGS RD
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City | SUTHERLAND
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State | VA
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Zip | 23885-9265
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Country | US
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Telephone | 804-721-9929
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | CEASIA KENYEDA CLANTON
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Credential | RN
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Telephone | 804-721-9929
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number |
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License Number State |
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