JADE COMMUNITY RESIDENTIAL CARE LLC (NPI# 1942445051) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1942445051 |
| Entity Type | Organization |
| Organization Name | JADE COMMUNITY RESIDENTIAL CARE LLC |
| Practice Address |
3 & 5 Cunnington Street Charleston SC 39405 |
| Mailing Address |
Post Office Box 21877 3 & 5 Cunnington Street Charleston SC 29405 |
| Practice Telephone | 8438530299 |
| Mailing Telephone | 8438530299 |
| Enumeration Date | 2008-12-04 |
| Last Update Date | 2008-12-04 |
| Authorized Official Name | MS. JULIA M. VELASCO (ADMINISTRATOR/OWNER) |
| Authorized Official Telephone | 8438536885 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320800000X | Community Based Residential Treatment Facility, Mental Illness | CRC 1123 | SC | Residential Treatment Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386880425 | Jade Community Residential Care LLC | Assisted Living Facility | 9 Cunnington Street, Charleston, SC 29413 | 2008-12-19 |
| 1366688400 | Jade Community Residential Care LLC | Assisted Living Facility | 7a & 7b Cunnington St, Charleston, SC 29413 | 2008-12-19 |
| Street Address |
3 & 5 CUNNINGTON STREET |
| City | CHARLESTON |
| State | SC |
| Zip Code | 39405 |
| 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 | 320800000X |
| Grouping | Residential Treatment Facilities |
| Classification | Community Based Residential Treatment Facility, Mental Illness |
| A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033411905 | Daymark Inc. | Community Based Residential Treatment Facility, Mental Illness | 1583 Lee St E, Charleston, WV 25311-2403 | 2010-11-29 |
| 1548448913 | Coles County Mental Health Association, Inc. | Community Based Residential Treatment Facility, Mental Illness | 1504 20th St, Charleston, IL 61920-3615 | 2008-02-07 |
| 1164600979 | Coles County Mental Health Association, Inc. | Community Based Residential Treatment Facility, Mental Illness | 415 18th St, Charleston, IL 61920-2399 | 2008-02-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124586599 | Lucille Manor Community Residential Care, LLP | Community Based Residential Treatment Facility, Mental Illness | 1004 R L Coward Rd, Eastover, SC 29044-9455 | 2019-03-05 |
| 1497290852 | Carolina Roses of Blythewood LLC | Community Based Residential Treatment Facility, Mental Illness | 5338 Hardscrabble Rd, Blythewood, SC 29016 | 2016-12-21 |
| 1568912285 | Cbh of Anderson, Operating, LLC | Community Based Residential Treatment Facility, Mental Illness | 313 Williams St, Williamston, SC 29697-1928 | 2016-10-05 |
| 1235592072 | Dodababy Inc | Community Based Residential Treatment Facility, Mental Illness | 1775 Commissary St, N Charleston, SC 29405-1905 | 2016-03-30 |
| 1962880690 | Butterfly Services LLC | Community Based Residential Treatment Facility, Mental Illness | 1562 Fred Davis Road, Cheraw, SC 29520 | 2015-05-14 |
| 1144639881 | Mary's Angels Independent Living for Young Women | Community Based Residential Treatment Facility, Mental Illness | 29 Sunflower Dr, Cades, SC 29518-3312 | 2014-08-06 |
| 1730510066 | Elizabeth Bledsoe | Community Based Residential Treatment Facility, Mental Illness | 924 Barr Woods Rd, Saluda, SC 29138-8191 | 2013-12-12 |
| 1013256080 | Amikids Palmetto, Inc. | Community Based Residential Treatment Facility, Mental Illness | 780 T Bishop Rd, Jonesville, SC 29353-2342 | 2013-02-11 |
| 1811234206 | Carolina Health and Wellness | Community Based Residential Treatment Facility, Mental Illness | 317 Silver Fox Ln, Columbia, SC 29212-2491 | 2013-01-06 |
| 1033499827 | Joyce C Gregory | Community Based Residential Treatment Facility, Mental Illness | 2415 Fork Shoals Rd, Piedmont, SC 29673 | 2011-08-24 |
| Find all providers with the same taxonomy | ||||
| City | CHARLESTON |
| Zip Code | 39405 |
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| 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.