Healthcare Provider Details

I. General information

NPI: 1740680834
Provider Name (Legal Business Name): CHRISTINAS CONTINUED CARING HOME HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/26/2014
Last Update Date: 08/26/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15 ASPEN WAY
NARROWSBURG NY
12764-5200
US

IV. Provider business mailing address

15 ASPEN WAY
NARROWSBURG NY
12764-5200
US

V. Phone/Fax

Practice location:
  • Phone: 845-252-7556
  • Fax: 570-729-7242
Mailing address:
  • Phone: 845-252-7556
  • Fax: 570-729-7242

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License Number252233
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number252233
License Number StateNY

VIII. Authorized Official

Name: MRS. CHRISTINA MARIE CRANDALL
Title or Position: OWNER
Credential: LPN
Phone: 845-252-7556