Organization
NC COMMUNITY CARE SERVICES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RHONDA ANN CROCKETT (CEO)
(404) 719-9549
Entity
Organization
Contact information
Practice address
555 FAYETTEVILLE STREET, STE. 201, RALEIGH, NC 27601
(919) 584-8333
(919) 584-8337
Mailing address
555 FAYETTEVILLE STREET, SUITE 201, RALEIGH, NC 27601
(919) 584-8333
(919) 584-8337
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
—
NC
251E00000X
Home Health Agency
Primary
—
NC
310400000X
Assisted Living Facility
—
NC
3104A0630X
Assisted Living Facility (Behavioral Disturbances)
—
NC
314000000X
Skilled Nursing Facility
—
NC
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
—
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
123654789
—
NC
Enumeration date
03/08/2017
Last updated
03/24/2017
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