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CCJ ADULT CARE LLC
NPI 1063189678
Custodial Care Facility - Adult Care Home in Crouse, NC

Active since August 23, 2021
1230 SAINT MARKS CHURCH RD, CROUSE, NC 28033(704) 769-4101 Get Directions Write a Review

NPPES record last updated: August 23, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Ccj Adult Care Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CCJ ADULT CARE LLC (NPI 1063189678) is a healthcare organization registered as an adult care home in Crouse, North Carolina and active in the NPI registry since August 2021. The organization maintains a secondary practice location in Gastonia and lists Bernice R Hosch, Administrator/operator, as its authorized official.

NPPES Registry Identity

NPI1063189678
Entity TypeOrganization
Primary Taxonomy311ZA0620X
Legal Business NameCCJ ADULT CARE LLC
Location Address1230 SAINT MARKS CHURCH RDCrouse, NC 28033-9600
Mailing AddressPo Box 74Bessemer City, NC 28016-0074 · (980) 295-3020
Phone(704) 769-4101
Organization SubpartNo
Authorized OfficialBernice R HoschAdministrator/operator · (980) 295-3020
Enumeration DateAugust 23, 2021
NPPES CertifiedAugust 23, 2021
✔ NPI 1063189678 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCustodial Care Facility · Adult Care HomeNursing & Custodial Care Facilities
Taxonomy Code311ZA0620X
Definition
A custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like environment.
1230 SAINT MARKS CHURCH RD, Crouse, NC 28033
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Other Names 2

Doing Business AsCcj Adult Care Llc
Doing Business AsSt' Mark Road Care Home

Secondary Practice Location 1

Location 1100 W Main Ave Apt 302Gastonia, NC 28052-4172 · Phone (980) 295-3020

Other Identifiers 1

OtherFCL-036-034NC · Family Care Home

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Ccj Adult Care LLC's NPI number?

The NPI number for Ccj Adult Care LLC is 1063189678. It was assigned to this organization in the NPPES registry on August 23, 2021. The provider is doing business as St' Mark Road Care Home.

Where is Ccj Adult Care LLC located?

Ccj Adult Care LLC is located at 1230 Saint Marks Church Rd, Crouse, NC 28033. The listed phone number is (704) 769-4101.

What is Ccj Adult Care LLC's specialty?

The primary specialty registered for this NPI is Custodial Care Facility, specializing in Adult Care Home, with taxonomy code 311ZA0620X.

When was this NPI record last updated?

The NPPES record for Ccj Adult Care LLC was last updated on August 23, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.