Healthcare Provider Details

I. General information

NPI: 1508772955
Provider Name (Legal Business Name): CRESPO'S HOME HEALTH CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/24/2026
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9200 ACADEMY RD
PHILADELPHIA PA
19114-3612
US

IV. Provider business mailing address

4710 ASHBURNER ST
PHILADELPHIA PA
19136-2920
US

V. Phone/Fax

Practice location:
  • Phone: 267-584-9912
  • Fax:
Mailing address:
  • Phone: 267-584-9912
  • Fax: 267-584-9912

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: JOSE CRESPO
Title or Position: CEO
Credential:
Phone: 267-584-9912