NPIMap

Organization Active NPI

CCC Healthcare, LLC

  • Intellectual and/or Developmental Disabilities Residential Treatment Facility
  • Bowie, MD
National Provider Identifier
1043749468
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X
Legal business name
CCC HEALTHCARE, LLC
Practice address
4205 Hatties Progress Drive
Bowie, MD 20720
Phone
(908) 463-3115
NPI assigned
Jun 8, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Solomon Nchinda
Title
Director
Phone
(908) 463-3115

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X Primary

Addresses

Primary practice location

4205 Hatties Progress Drive
Bowie, MD 20720

Mailing address

4205 Hatties Progress Dr
Bowie, MD 20720-6321
Phone (908) 463-3115

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1496880000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1043749468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4205 HATTIES PROGRESS DR",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207206321",
            "telephone_number": "908-463-3115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4205 HATTIES PROGRESS DRIVE",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "20720",
            "telephone_number": "908-463-3115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CCC HEALTHCARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-08",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "NCHINDA",
        "authorized_official_first_name": "SOLOMON",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "908-463-3115",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bowie, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.