Provider Demographics
NPI:1154118669
Name:CCJOY LLC
Entity type:Organization
Organization Name:CCJOY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTY
Authorized Official - Middle Name:JOY
Authorized Official - Last Name:KIESCHNICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-761-0496
Mailing Address - Street 1:3557 PETUNIA CRES # VA
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23453-2205
Mailing Address - Country:US
Mailing Address - Phone:757-761-0496
Mailing Address - Fax:757-761-0496
Practice Address - Street 1:3557 PETUNIA CRES # VA
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23453-2205
Practice Address - Country:US
Practice Address - Phone:757-761-0496
Practice Address - Fax:757-761-0496
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-21
Last Update Date:2025-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care