Jewel Community Care LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

JEWEL COMMUNITY CARE LLC

Practice address

1003 W Main St Ste B2
Haw River, NC 27258-8931

Phone

(877) 775-3935

Fax

(866) 545-3560

NPI assigned

Jul 29, 2021

Last updated

Jul 29, 2021By the provider in NPPES

Organization subpart

Yes

Parent organization

JEWEL COMMUNITY CARE LLCAs reported in NPPES

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

Authorized official

Name

Crystal D Bush, LCSW LCAS LISW-CPNPI 1265532527

Title

Clinical Director

Phone

(984) 292-4235

Specialties & licenses 1

Addresses

Other names 1

• Jewel Community Care- Alamance Other name

Tax ID family

Jewel Community Care LLC2 organizations share this tax ID, including this one

Part of

Jewel Community Care LLC

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Jewel Community Care LLC

  • Community/Behavioral Health Agency
  • Monroe, NC
  • NPI 1639842883
  NPD tax ID

Locations

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Jewel Community Care LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Reidsville, NC
  • NPI 1841813177
  NPPES parent name

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Crystal Denee Bush, LCSW, LCAS, LISW-CP

  • Clinical Social Worker
  • Durham, NC
  • NPI 1265532527
  NPD (past) Authorized official

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

{
    "created_epoch": "1627516800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1627516800000",
    "number": "1558034181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1712 SUN STAR DR",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276107281",
            "telephone_number": "919-649-0903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1003 W MAIN ST STE B2",
            "city": "HAW RIVER",
            "state": "NC",
            "postal_code": "272588931",
            "telephone_number": "877-775-3935",
            "fax_number": "866-545-3560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEWEL COMMUNITY CARE LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "JEWEL COMMUNITY CARE LLC",
        "enumeration_date": "2021-07-29",
        "last_updated": "2021-07-29",
        "certification_date": "2021-07-29",
        "status": "A",
        "authorized_official_last_name": "BUSH",
        "authorized_official_first_name": "CRYSTAL",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "984-292-4235",
        "authorized_official_credential": "LCSW LCAS LISW-CP"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jewel Community Care- Alamance",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Jacobe Leon Douglas, MSA, CCM, LCSWA
• Brandy Michelle Faucette, NP
• Cameron Bryant Gibson, PHARMD
• Haw River Drug Inc (Haw River Discount Drug)
• Haw River Pharmacy LLC (Haw River Pharmacy)
• Snjezana Joksimovic
• Lewis Leander Newman Jr., PA
• Pharmacure Health Center LLC
• Ralph Scott Lifeservices Inc
• Eureka Deniece Shaw, BSN,RN

• Community/Behavioral Health Agency in Haw River, NC
• Providers in Haw River, NC by specialty
• Community/Behavioral Health Agency in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2021; 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.