Provider Demographics
NPI:1689203911
Name:C & C RECOVERY, LLC
Entity Type:Organization
Organization Name:C & C RECOVERY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOANN
Authorized Official - Middle Name:S
Authorized Official - Last Name:CHRISTIAN
Authorized Official - Suffix:
Authorized Official - Credentials:AADC
Authorized Official - Phone:304-995-2367
Mailing Address - Street 1:198 HUNTFIELD LN
Mailing Address - Street 2:
Mailing Address - City:CHARLES TOWN
Mailing Address - State:WV
Mailing Address - Zip Code:25414-2543
Mailing Address - Country:US
Mailing Address - Phone:703-599-9524
Mailing Address - Fax:
Practice Address - Street 1:225 AUGUSTINE AVE
Practice Address - Street 2:
Practice Address - City:CHARLES TOWN
Practice Address - State:WV
Practice Address - Zip Code:25414-4431
Practice Address - Country:US
Practice Address - Phone:681-252-3334
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:C & C RECOVERY, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-04-07
Last Update Date:2020-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)