Provider Demographics
NPI:1023310901
Name:CKC HOLDINGS LLC
Entity type:Organization
Organization Name:CKC HOLDINGS LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:DANIEL
Authorized Official - Last Name:PORTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-237-0100
Mailing Address - Street 1:1000 W CROSBY RD
Mailing Address - Street 2:SUITE 136
Mailing Address - City:CARROLLTON
Mailing Address - State:TX
Mailing Address - Zip Code:75006-6935
Mailing Address - Country:US
Mailing Address - Phone:972-237-0100
Mailing Address - Fax:972-237-0101
Practice Address - Street 1:1000 W CROSBY RD
Practice Address - Street 2:SUITE 136
Practice Address - City:CARROLLTON
Practice Address - State:TX
Practice Address - Zip Code:75006-6935
Practice Address - Country:US
Practice Address - Phone:972-237-0100
Practice Address - Fax:972-237-0101
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-24
Last Update Date:2024-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX218889801Medicaid