Provider Demographics
NPI:1700021656
Name:C&C LTD
Entity Type:Organization
Organization Name:C&C LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:SHAWN
Authorized Official - Middle Name:A
Authorized Official - Last Name:COLE
Authorized Official - Suffix:
Authorized Official - Credentials:N/A
Authorized Official - Phone:954-464-6371
Mailing Address - Street 1:7161 SILVER LAKE BLVD
Mailing Address - Street 2:SUITE #201
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22315-3216
Mailing Address - Country:US
Mailing Address - Phone:954-464-6371
Mailing Address - Fax:
Practice Address - Street 1:7161 SILVER LAKE BLVD
Practice Address - Street 2:SUITE #201
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22315-3216
Practice Address - Country:US
Practice Address - Phone:954-464-6371
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-06
Last Update Date:2008-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0855483251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health