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General NPI Number Information
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NPI Number | 1508581216
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Entity Type | Organization
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Legal Business Name | CRISP HOME CARE, LLC
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Dates
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Enumeration Date | 10/05/2022
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Last Update Date | 10/05/2022
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Provider Practice Location Address
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Address Line | 525 WOODLAND SQUARE BLVD
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City | CONROE
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State | TX
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Zip | 77384-2211
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Country | US
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Telephone | 936-283-4409
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Fax |
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Provider Business Mailing Address
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Address Line | 26114 CROWN RANCH BLVD
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City | MONTGOMERY
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State | TX
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Zip | 77316-1914
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Country | US
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Telephone | 936-283-4409
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Fax |
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Authorized Official
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Title or Position | CERTIFIED SENIOR CARE MANAGER
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Name | SAULE SHYNTEMIROVA
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Credential |
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Telephone | 832-420-1324
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 385H00000X
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Taxonomy Name | Respite Care
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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