Provider Demographics
NPI:1164807020
Name:CHINESE CULTURE AND COMMUNITY SERVICES CENTER, INC.
Entity Type:Organization
Organization Name:CHINESE CULTURE AND COMMUNITY SERVICES CENTER, INC.
Other - Org Name:CCACC HOME CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CHIH-HSIANG
Authorized Official - Middle Name:
Authorized Official - Last Name:LI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-820-7200
Mailing Address - Street 1:9366 GAITHER RD
Mailing Address - Street 2:
Mailing Address - City:GAITHERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20877-1416
Mailing Address - Country:US
Mailing Address - Phone:301-820-7200
Mailing Address - Fax:240-823-6060
Practice Address - Street 1:9366 GAITHER RD
Practice Address - Street 2:
Practice Address - City:GAITHERSBURG
Practice Address - State:MD
Practice Address - Zip Code:20877-1416
Practice Address - Country:US
Practice Address - Phone:301-820-7200
Practice Address - Fax:240-823-6060
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-21
Last Update Date:2015-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR3795P253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care