Provider Demographics
NPI:1679895098
Name:CCP HEALTH AND HOME CARE SERVICES, INC
Entity Type:Organization
Organization Name:CCP HEALTH AND HOME CARE SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:WINSTON
Authorized Official - Middle Name:
Authorized Official - Last Name:BRAMWELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-651-6057
Mailing Address - Street 1:5230 S UNIVERSITY DR STE 103D
Mailing Address - Street 2:
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33328-5319
Mailing Address - Country:US
Mailing Address - Phone:954-651-6057
Mailing Address - Fax:954-651-6058
Practice Address - Street 1:4801 S UNIVERSITY DRIVE
Practice Address - Street 2:SUITE 206
Practice Address - City:DAVIE
Practice Address - State:FL
Practice Address - Zip Code:33328-3837
Practice Address - Country:US
Practice Address - Phone:954-651-6057
Practice Address - Fax:954-651-6058
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-26
Last Update Date:2024-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL30211434251J00000X
253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251J00000XAgenciesNursing Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL121359500Medicaid