Healthcare Provider Details

I. General information

NPI: 1235865353
Provider Name (Legal Business Name): CRESCENT HEALTH GROUP, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/29/2022
Last Update Date: 06/23/2023
Certification Date: 06/23/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8211 GOODWOOD BLVD STE A1
BATON ROUGE LA
70806-7740
US

IV. Provider business mailing address

8211 GOODWOOD BLVD STE A1
BATON ROUGE LA
70806-7740
US

V. Phone/Fax

Practice location:
  • Phone: 225-421-1921
  • Fax:
Mailing address:
  • Phone: 225-421-1921
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: DR. SHALANDA RECHEL JUDGE
Title or Position: DIRECTOR/OWNER
Credential:
Phone: 225-421-1921