Provider Demographics
NPI:1447598578
Name:CCJ HOME CARE LLC
Entity Type:Organization
Organization Name:CCJ HOME CARE LLC
Other - Org Name:SUNSHINE HOME HEALTH CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:CARLOS
Authorized Official - Middle Name:
Authorized Official - Last Name:ARANDA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-683-0777
Mailing Address - Street 1:522 S 11TH ST
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78501-4920
Mailing Address - Country:US
Mailing Address - Phone:956-683-0777
Mailing Address - Fax:956-683-0778
Practice Address - Street 1:522 S 11TH ST
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78501-4920
Practice Address - Country:US
Practice Address - Phone:956-683-0777
Practice Address - Fax:956-683-0778
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-24
Last Update Date:2022-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251C00000X, 253Z00000X, 291U00000X
TX017044251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No253Z00000XAgenciesIn Home Supportive Care
No291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX319891302Medicaid
TX319891301Medicaid