# CCM HEALTHCARE, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1982421095
- **Authorized official:** MRS. GRETCHEN ANN MACHESNEY NP (OWNER)
- **Authorized official phone:** (240) 718-4820

## Contact information

- **Practice address:** 42925 HUNGERFORD CT, HOLLYWOOD, MD 20636-3278
- **Practice address phone:** (240) 718-4820
- **Practice address fax:** (657) 699-1592
- **Mailing address:** 42925 HUNGERFORD CT, HOLLYWOOD, MD 20636-3278
- **Mailing address phone:** (775) 771-6830

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LA2200X | Adult Health Nurse Practitioner | — | NULL | Yes |
| 363LA2200X | Adult Health Nurse Practitioner | — | — | Yes |
| 363LC1500X | Community Health Nurse Practitioner | — | NULL | — |
| 363LC1500X | Community Health Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 09/21/2024
- **Last updated:** 07/09/2025