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General NPI Number Information
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NPI Number | 1720269772
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Entity Type | Organization
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Legal Business Name | CCGJ & P INC.
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Dates
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Enumeration Date | 11/19/2007
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Last Update Date | 11/19/2007
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Provider Practice Location Address
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Address Line | 5263 GOLDEN GATE PKWY SUITE B
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City | NAPLES
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State | FL
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Zip | 34116-7601
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Country | US
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Telephone | 239-353-2273
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Fax | 239-774-2273
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Provider Business Mailing Address
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Address Line | 5263 GOLDEN GATE PKWY SUITE B
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City | NAPLES
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State | FL
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Zip | 34116-7601
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Country | US
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Telephone | 239-353-2273
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Fax | 239-774-2273
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Authorized Official
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Title or Position | OPERATIONS MANAGER
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Name | MS. TRISHA LEE MCPHERSON
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Credential |
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Telephone | 239-353-2273
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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