Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Ccc of Fair Play, LLC

Organization Assisted Living Facility · NPI 1912216565

Ccc of Fair Play, LLC is an Assisted Living Facility in Fair Play, South Carolina. Licensed in South Carolina. Registered with an NPI since 2010.

Licensed in
SC
In the registry since
2010
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

207 Farm House Ln
Fair Play, SC 29643-2207
Phone: (864) 972-1072
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Assisted Living Facility (primary) Taxonomy 310400000X · Licence CRC1041 (SC)

Record details

NPI number1912216565
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Jeffrey Shore — President · (610) 203-0210
NPI enumeratedSeptember 30, 2010
Last updated in NPPESSeptember 30, 2010
Mailing address207 Farm House Ln, Fair Play, SC 29643-2207

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