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General NPI Number Information
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NPI Number | 1245677517
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Entity Type | Organization
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Legal Business Name | CRC HOME HEALTH INC
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Dates
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Enumeration Date | 05/28/2013
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Last Update Date | 05/28/2013
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Provider Practice Location Address
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Address Line | 4360 PRESTIGE PT
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City | COLORADO SPRINGS
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State | CO
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Zip | 80906-6090
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Country | US
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Telephone | 719-217-2457
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 17262
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City | COLORADO SPRINGS
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State | CO
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Zip | 80935-7262
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Country | US
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Telephone | 719-217-2457
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | MR. CHAD A ROUNDS
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Credential | CARE GIVER
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Telephone | 719-217-2457
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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