Crown Care Corporation

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

Legal business name

CROWN CARE CORPORATION

Practice address

5100 Buckeystown Pike
Frederick, MD 21704-8336

Phone

(240) 416-1579

NPI assigned

Mar 11, 2024

Organization subpart

No

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

Authorized official

Name

Adegbenga Benjamin Kiladejo

Title

Manager

Phone

(240) 416-1579

Specialties & licenses 1

Addresses

Other names 1

• CCC Homes Other name

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

{
    "created_epoch": "1710115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710115200000",
    "number": "1265290712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5403 RICHARDSONS ENDEAVOR DR",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207203390",
            "telephone_number": "240-416-1579"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5100 BUCKEYSTOWN PIKE",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217048336",
            "telephone_number": "240-416-1579"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CROWN CARE CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-11",
        "last_updated": "2024-03-11",
        "certification_date": "2024-03-09",
        "status": "A",
        "authorized_official_last_name": "KILADEJO",
        "authorized_official_first_name": "ADEGBENGA",
        "authorized_official_middle_name": "BENJAMIN",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "240-416-1579"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CCC Homes",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Frederick, MD
• Providers in Frederick, MD by specialty
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2024; 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.