Healthcare Provider Details

I. General information

NPI: 1790790491
Provider Name (Legal Business Name): CITY CROWN HOME HEALTH AGENCY INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/30/2006
Last Update Date: 06/22/2020
Certification Date: 06/22/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1560 W BAY AREA BLVD STE 230
FRIENDSWOOD TX
77546-2678
US

IV. Provider business mailing address

1560 W BAY AREA BLVD STE 230
FRIENDSWOOD TX
77546-2678
US

V. Phone/Fax

Practice location:
  • Phone: 281-486-2020
  • Fax: 281-486-2096
Mailing address:
  • Phone: 281-486-2020
  • Fax: 281-486-2096

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: MR. EPHRAIM E. OKAFOR
Title or Position: ALT. ADMINISTRATOR
Credential: BS; BBA; MBA
Phone: 281-486-2020