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General NPI Number Information
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NPI Number | 1821233206
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Entity Type | Organization
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Legal Business Name | CRESCENT HOME HEALTH CARE INC.
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Dates
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Enumeration Date | 12/12/2008
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Last Update Date | 12/12/2008
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Provider Practice Location Address
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Address Line | 96 RIVER OAKS CENTER DR STE 211
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City | CALUMET CITY
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State | IL
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Zip | 60409-5504
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Country | US
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Telephone | 708-268-4006
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Fax | 708-524-0514
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Provider Business Mailing Address
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Address Line | 96 RIVER OAKS CENTER DR STE 211
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City | CALUMET CITY
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State | IL
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Zip | 60409-5504
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Country | US
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Telephone | 708-268-4006
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Fax | 708-524-0514
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Authorized Official
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Title or Position | PRESIDENT
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Name | MISS MARY M CHINNAM
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Credential |
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Telephone | 708-268-4006
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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 | IL
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