JADE COMMUNITY RESIDENTIAL CARE LLC (NPI# 1386880425) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386880425 |
| Entity Type | Organization |
| Organization Name | JADE COMMUNITY RESIDENTIAL CARE LLC |
| Other Organization Name | JADE COMMUNITY RESIDENTIAL CARE III |
| Practice Address |
9 Cunnington Street Charleston SC 29413 |
| Mailing Address |
Po Box 21877 9 Cunnington Street Charleston SC 29413 |
| Practice Telephone | 8438530299 |
| Mailing Telephone | 8438530299 |
| Enumeration Date | 2008-12-19 |
| Last Update Date | 2008-12-19 |
| Authorized Official Name | MS. JULIA M. VELASCO (OWNER) |
| Authorized Official Telephone | 8438536885 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 310400000X | Assisted Living Facility | CRC1125 | SC | Nursing & Custodial Care Facilities |
| Other Name | Type Code |
|---|---|
| Jade Community Residential Care III | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366688400 | Jade Community Residential Care LLC | Assisted Living Facility | 7a & 7b Cunnington St, Charleston, SC 29413 | 2008-12-19 |
| 1942445051 | Jade Community Residential Care LLC | Community Based Residential Treatment Facility, Mental Illness | 3 & 5 Cunnington Street, Charleston, SC 39405 | 2008-12-04 |
| Street Address |
9 CUNNINGTON STREET |
| City | CHARLESTON |
| State | SC |
| Zip Code | 29413 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366688400 | Jade Community Residential Care LLC | Assisted Living Facility | 7a & 7b Cunnington St, Charleston, SC 29413 | 2008-12-19 |
| 1114019247 | Veronica Jeanne Walters | Nurse Practitioner | 30 Bee Street, Charleston, SC 29413 | 2006-09-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568063402 | Jovon Minimah-beane | Technician | 612 Virginia St E Ste 300, Charleston, WV 25301-2175 | 2020-11-06 |
| 1811598832 | Jessica Nogoda | Technician | 1002 Hillcrest Dr E, Charleston, WV 25311-1612 | 2020-11-05 |
| 1245831221 | Jeriaha Hall | Technician | 2511 Washington St E Apt C, Charleston, WV 25311-2316 | 2020-11-05 |
| 1679174957 | Shasta Lashea Evans | Technician | 5916 Starling Dr, Charleston, WV 25306-6045 | 2020-11-04 |
| 1184225476 | Darlene Lacy-carter | Technician | 1406 Milton Street, Charleston, WV 25311 | 2020-11-04 |
| 1760083927 | Kimberly Adele Hughes | Psychologist | 310 Cambridge Pointe, Charleston, WV 25309-8596 | 2020-11-04 |
| 1851992135 | Shonda Latoya Leach | Technician | 821 Westminister Way, Charleston, WV 25314-2015 | 2020-11-04 |
| 1265033559 | Nancy Galvan | Technician | 4587 Kanawha State Forrest Dr., Charleston, WV 25314 | 2020-11-04 |
| 1093316424 | Emma Mccloud | Technician | 710 Colony Dr., Charleston, WV 25314 | 2020-11-03 |
| 1760083190 | Terri Lea James | Technician | 5810 Church Dr., Charleston, WV 25306 | 2020-11-03 |
| Find all providers in CHARLESTON | ||||
| Taxonomy Code | 310400000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Assisted Living Facility |
| A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063024156 | Snh Se Ashley River Tenant LLC | Assisted Living Facility | 2330 Ashley River Rd, Charleston, SC 29414-4752 | 2020-08-19 |
| 1942847157 | Indigo Hall Operating Co, LLC | Assisted Living Facility | 509 Standard Way, Charleston, SC 29412-2397 | 2019-12-06 |
| 1225526650 | Jonathan and Blessing LLC | Assisted Living Facility | 5312 Morning Dove Ln, Charleston, WV 25313-1154 | 2018-05-01 |
| 1639513963 | Lincoln Trail Place Limited Parternership | Assisted Living Facility | 480 W Polk Ave, Charleston, IL 61920-3291 | 2013-04-17 |
| 1366688400 | Jade Community Residential Care LLC | Assisted Living Facility | 7a & 7b Cunnington St, Charleston, SC 29413 | 2008-12-19 |
| 1174771562 | Nhc Place-charleston LLC | Assisted Living Facility | 1900 Ashley Crossing Dr, Charleston, SC 29414-5752 | 2008-08-28 |
| 1508933854 | Charleston Alf Operations LLC | Assisted Living Facility | 699 S Park Rd, Charleston, WV 25304-2627 | 2006-11-30 |
| 1144836164 | Bkd Charleston South Carolina, LLC | Assisted Living Facility | 2030 Charlie Hall Blvd, Charleston, SC 29414-5830 | 2020-09-16 |
| 1306334750 | Blessing O Eya | Assisted Living Facility | 5312 Morning Dove Ln, Charleston, WV 25313-1154 | 2018-05-01 |
| 1841454279 | Oak Haven Senior Living | Assisted Living Facility | 2333 Ashley River Rd, Charleston, SC 29414-4755 | 2008-07-15 |
| Find all providers in CHARLESTON | ||||
| City | CHARLESTON |
| Zip Code | 29413 |
Please comment or provide details below to improve the information on JADE COMMUNITY RESIDENTIAL CARE LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.