Provider Demographics
NPI:1679716609
Name:CCRC HEALTHCARE, INC.
Entity type:Organization
Organization Name:CCRC HEALTHCARE, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER, PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:CHAD
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-452-9800
Mailing Address - Street 1:3810 MEDICAL PKWY STE 203
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78756-4014
Mailing Address - Country:US
Mailing Address - Phone:512-452-9800
Mailing Address - Fax:512-452-9801
Practice Address - Street 1:3810 MEDICAL PKWY STE 203
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78756-4014
Practice Address - Country:US
Practice Address - Phone:512-452-9800
Practice Address - Fax:512-452-9801
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-07
Last Update Date:2009-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health