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Organization
CCJ ADULT CARE LLC
Active
Organization
CCJ ADULT CARE LLC
Active
Other names
St' Mark Road Care Home, CCJ Adult Care LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MS. BERNICE R HOSCH (ADMINISTRATOR/OPERATOR)
(980) 295-3020
Entity
Organization
Contact information
Practice address
1230 SAINT MARKS CHURCH RD, CROUSE, NC 28033-9600
(704) 769-4101
Mailing address
PO BOX 74, BESSEMER CITY, NC 28016-0074
(980) 295-3020
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
FCL-036-034
FAMILY CARE HOME
NC
Enumeration date
08/23/2021
Last updated
08/23/2021
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