Provider Demographics
NPI:1669678983
Name:C AND S HEALTH CARE AGENCY
Entity Type:Organization
Organization Name:C AND S HEALTH CARE AGENCY
Other - Org Name:CALDWELL HOUSE #1
Other - Org Type:Other Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:LEVERNE
Authorized Official - Last Name:CALDWELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-837-7087
Mailing Address - Street 1:2901 HOLMES RD
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27405-4621
Mailing Address - Country:US
Mailing Address - Phone:336-837-7087
Mailing Address - Fax:336-358-1699
Practice Address - Street 1:2901 HOLMES RD
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27405-4621
Practice Address - Country:US
Practice Address - Phone:336-837-7087
Practice Address - Fax:336-358-1699
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCMHL-041-823320600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities