Provider Demographics
NPI:1659061463
Name:CC&A HOMES INC
Entity Type:Organization
Organization Name:CC&A HOMES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:EDITH
Authorized Official - Middle Name:OFUNNEAMAKA
Authorized Official - Last Name:CHIDI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-280-9876
Mailing Address - Street 1:3203 SHEKHAR CT
Mailing Address - Street 2:
Mailing Address - City:SPRINGDALE
Mailing Address - State:MD
Mailing Address - Zip Code:20774-2577
Mailing Address - Country:US
Mailing Address - Phone:240-280-9876
Mailing Address - Fax:
Practice Address - Street 1:3203 SHEKHAR CT
Practice Address - Street 2:
Practice Address - City:SPRINGDALE
Practice Address - State:MD
Practice Address - Zip Code:20774-2577
Practice Address - Country:US
Practice Address - Phone:240-280-9876
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-15
Last Update Date:2023-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care
No320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities