Provider Demographics
NPI:1609494897
Name:P&C ADULT CARE LLC
Entity Type:Organization
Organization Name:P&C ADULT CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER MANGER/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:CASEY
Authorized Official - Middle Name:
Authorized Official - Last Name:BLACK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-239-2199
Mailing Address - Street 1:1002 BELL RIDGE CT
Mailing Address - Street 2:
Mailing Address - City:ROCKWELL
Mailing Address - State:NC
Mailing Address - Zip Code:28138-7437
Mailing Address - Country:US
Mailing Address - Phone:704-239-2199
Mailing Address - Fax:704-856-8196
Practice Address - Street 1:1345 CHAPMAN LN
Practice Address - Street 2:
Practice Address - City:NEWTON
Practice Address - State:NC
Practice Address - Zip Code:28658-1778
Practice Address - Country:US
Practice Address - Phone:828-464-6490
Practice Address - Fax:828-466-3002
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-14
Last Update Date:2020-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home