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General NPI Number Information
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NPI Number | 1346048436
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Entity Type | Organization
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Legal Business Name | CC CARE LLC
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Dates
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Enumeration Date | 03/04/2025
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Last Update Date | 03/04/2025
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Provider Practice Location Address
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Address Line | 4249 SHEFFIELD RD
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City | RICHMOND
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State | VA
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Zip | 23224-4845
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Country | US
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Telephone | 240-726-3042
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Fax |
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Provider Business Mailing Address
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Address Line | 307 KARL LINN DR APT 421
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City | NORTH CHESTERFIELD
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State | VA
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Zip | 23225-6977
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Country | US
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Telephone | 240-726-3042
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | TONIA COKER
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Credential |
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Telephone | 240-726-3042
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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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