MEDICARE: CKC HOLDINGS LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1023310901
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CKC HOLDINGS LLC

Provider Business Mailing Address
First Line	:	2021 E LAMAR BLVD
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76006
Country	:	US
Telephone Number	:	972-237-0100
Fax Number	:	972-237-0101

Provider Business Practice Location Address
First Line	:	2021 E LAMAR BLVD
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76006
Country	:	US
Telephone Number	:	972-237-0100
Fax Number	:	972-237-0101

Authorized Official
Title or Position	:	PRESIDENT/ADMINISTRATOR
Name	:	MR. CRAIG DANIEL PORTER
Credential	:
Telephone Number	:	972-237-0100

Provider Enumeration Date	:	11/24/2010
Last Update Date	:	12/05/2025

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