Healthcare Provider Details

I. General information

NPI: 1164489878
Provider Name (Legal Business Name): CRESCENTCARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/27/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9402 HIGHWAY 23
BELLE CHASSE LA
70037-2150
US

IV. Provider business mailing address

PO BOX 6757
NEW ORLEANS LA
70174-6757
US

V. Phone/Fax

Practice location:
  • Phone: 504-606-1050
  • Fax:
Mailing address:
  • Phone: 504-606-1050
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD024974
License Number StateLA
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD024974
License Number StateLA

VIII. Authorized Official

Name: CHRISTY L VALENTINE
Title or Position: OWNER/PHYSICIAN
Credential: M.D.
Phone: 504-606-1050