Provider Demographics
NPI:1164150306
Name:CCC HOME HEALTH LLC
Entity Type:Organization
Organization Name:CCC HOME HEALTH LLC
Other - Org Name:BELLA HOME HEALTH OF TEXAS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EX VP
Authorized Official - Prefix:
Authorized Official - First Name:PAT
Authorized Official - Middle Name:
Authorized Official - Last Name:PATTERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:601-582-6031
Mailing Address - Street 1:900 WIGGINS PKWY STE B
Mailing Address - Street 2:
Mailing Address - City:MESQUITE
Mailing Address - State:TX
Mailing Address - Zip Code:75150-1400
Mailing Address - Country:US
Mailing Address - Phone:972-613-7945
Mailing Address - Fax:972-682-7947
Practice Address - Street 1:900 WIGGINS PKWY STE B
Practice Address - Street 2:
Practice Address - City:MESQUITE
Practice Address - State:TX
Practice Address - Zip Code:75150-1400
Practice Address - Country:US
Practice Address - Phone:972-613-7945
Practice Address - Fax:972-682-7947
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-14
Last Update Date:2022-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health