MEDICARE: CRESCENDO COMMUNITY CARE CORPORATION

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency	044R0095	GA

General Provider Information

NPI Number	:	1033454970
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CRESCENDO COMMUNITY CARE CORPORATION

Provider Business Mailing Address
First Line	:	1745 OLD SPRING HOUSE LN
Second Line	:	SUITE 405
City	:	ATLANTA
State	:	GA
Zip	:	30338-6216
Country	:	US
Telephone Number	:	770-392-8952
Fax Number	:	404-698-2950

Provider Business Practice Location Address
First Line	:	1745 OLD SPRING HOUSE LN
Second Line	:	SUITE 405
City	:	ATLANTA
State	:	GA
Zip	:	30338-6216
Country	:	US
Telephone Number	:	770-392-8952
Fax Number	:	404-698-2950

Authorized Official
Title or Position	:	OWNER
Name	:	MRS. IRENE M HARDIN
Credential	:
Telephone Number	:	770-392-8952

Provider Enumeration Date	:	12/04/2012
Last Update Date	:	12/04/2012

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