NPIMap

Organization Active NPI

Jade Community Residential Care LLC

  • Mental Illness Community Based Residential Treatment Facility
  • Charleston, SC
National Provider Identifier
1942445051
Registry record updated Dec 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X
License
CRC 1123 Issued in SC
Legal business name
JADE COMMUNITY RESIDENTIAL CARE LLC
Practice address
3 & 5 Cunnington Street
Charleston, SC 39405
Phone
(843) 853-0299
NPI assigned
Dec 4, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2008

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

Authorized official

Name
Ms. Julia M. Velasco
Title
Administrator/Owner
Phone
(843) 853-6885

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Illness Community Based Residential Treatment Facility 320800000X CRC 1123 SC Primary

Addresses

Primary practice location

3 & 5 Cunnington Street
Charleston, SC 39405

Mailing address

Post Office Box 21877
3 & 5 Cunnington Street
Charleston, SC 29405
Phone (843) 853-0299

National Provider Directory

National Provider Directory
Tax ID family
Jade Community Residential Care II3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

NPI Registry JSON

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

{
    "created_epoch": "1228348800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1228348800000",
    "number": "1942445051",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "POST OFFICE BOX 21877",
            "address_2": "3 & 5 CUNNINGTON STREET",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "29405",
            "telephone_number": "843-853-0299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 & 5 CUNNINGTON STREET",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "39405",
            "telephone_number": "843-853-0299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JADE COMMUNITY RESIDENTIAL CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-12-04",
        "last_updated": "2008-12-04",
        "status": "A",
        "authorized_official_last_name": "VELASCO",
        "authorized_official_first_name": "JULIA",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "ADMINISTRATOR/OWNER",
        "authorized_official_telephone_number": "843-853-6885",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "SC",
            "license": "CRC 1123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2008; 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.