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General NPI Number Information
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NPI Number | 1881324432
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Entity Type | Organization
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Legal Business Name | C & C HOUSE CARE LLC
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Dates
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Enumeration Date | 06/15/2022
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Last Update Date | 06/15/2022
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Provider Practice Location Address
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Address Line | 10516 SAMAGA DR
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City | OAKTON
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State | VA
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Zip | 22124-1630
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Country | US
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Telephone | 703-989-4197
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Fax |
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Provider Business Mailing Address
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Address Line | 10516 SAMAGA DR
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City | OAKTON
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State | VA
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Zip | 22124-1630
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Country | US
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Telephone | 703-989-4197
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Fax |
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | CARMEN HENDRICKS
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Credential |
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Telephone | 703-319-0959
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171WH0202X
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Taxonomy Name | Home Modifications Contractor
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License Number |
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License Number State |
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