Provider Demographics
NPI:1336583475
Name:CCJP, INC.
Entity Type:Organization
Organization Name:CCJP, INC.
Other - Org Name:SENIOR HELPERS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:KENT
Authorized Official - Middle Name:J
Authorized Official - Last Name:TERRY
Authorized Official - Suffix:III
Authorized Official - Credentials:
Authorized Official - Phone:717-738-0588
Mailing Address - Street 1:1060 S. STATE STREET
Mailing Address - Street 2:SUITE E
Mailing Address - City:EPHRATA
Mailing Address - State:PA
Mailing Address - Zip Code:17522
Mailing Address - Country:US
Mailing Address - Phone:717-738-0588
Mailing Address - Fax:717-738-0539
Practice Address - Street 1:1060 S. STATE STREET
Practice Address - Street 2:SUITE E
Practice Address - City:EPHRATA
Practice Address - State:PA
Practice Address - Zip Code:17522
Practice Address - Country:US
Practice Address - Phone:717-738-0588
Practice Address - Fax:717-738-0539
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-19
Last Update Date:2019-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA23343601253Z00000X
253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care