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
—
—
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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