GREENE HAVEN FAMILY CARE HOME
NPI 1215604822
Custodial Care Facility - Adult Care Home in Shelby, NC

Q: What is Ccj Adult Care III LLC's NPI number?

The NPI number for Ccj Adult Care III LLC is 1215604822. It was assigned to this organization in the NPPES registry on August 23, 2021. The provider is doing business as Greene Haven Family Care Home.

Q: What is Ccj Adult Care III LLC's specialty?

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

Active since August 23, 2021

1833 STONEY POINT RD, SHELBY, NC 28150(980) 295-3020 Get Directions Write a Review

NPPES record last updated: September 15, 2021. Verified against the NPPES registry weekly; last sync: August 30, 2026.

Record update history: Sep 15, 2021, Aug 23, 2021 (2 updates tracked since 2021).

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About Greene Haven Family Care Home NPPES

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

GREENE HAVEN FAMILY CARE HOME (NPI 1215604822) is a healthcare organization registered as an adult care home in Shelby, 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

NPI1215604822

Entity TypeOrganization

Primary Taxonomy311ZA0620X

Legal Business NameCCJ ADULT CARE III LLC

Location Address1833 STONEY POINT RDShelby, NC 28150-9601

Mailing AddressPo Box 74Bessemer City, NC 28016-0074 · (980) 295-3020

Phone(980) 295-3020

Organization SubpartNo

Authorized OfficialBernice R HoschAdministrator/operator · (980) 295-3020

Enumeration DateAugust 23, 2021

Last NPPES UpdateSeptember 15, 20212 updates tracked since enumeration

NPPES CertifiedSeptember 15, 2021

✔ NPI 1215604822 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.

1833 STONEY POINT RD, Shelby, NC 28150

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Other Names 1

Doing Business AsGreene Haven Family Care Home

Secondary Practice Location 1

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

Other Identifiers 1

OtherFCL-023-055NC · 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 III LLC's NPI number?

The NPI number for Ccj Adult Care III LLC is 1215604822. It was assigned to this organization in the NPPES registry on August 23, 2021. The provider is doing business as Greene Haven Family Care Home.

Where is Ccj Adult Care III LLC located?

Ccj Adult Care III LLC is located at 1833 Stoney Point Rd, Shelby, NC 28150. The listed phone number is (980) 295-3020.

What is Ccj Adult Care III 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 III LLC was last updated on September 15, 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.