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NPI Code Detail

MEDICARE: CROWNDESEA HEALTH CARE

MEDICARE: CROWNDESEA HEALTH CARE
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
1251E00000XHome Health Agency

General Provider Information

NPI Number : 1093949257
Entity Type Code : Organization
Provider Name (Legal Business Name) : CROWNDESEA HEALTH CARE
Provider Business Mailing Address
First Line : 7441 MARVIN D LOVE FWY STE 402
Second Line :
City : DALLAS
State : TX
Zip : 75237-3784
Country : US
Telephone Number : 972-283-6100
Fax Number :
Provider Business Practice Location Address
First Line : 7441 MARVIN D LOVE FWY STE 402
Second Line :
City : DALLAS
State : TX
Zip : 75237-3784
Country : US
Telephone Number : 972-283-6100
Fax Number :
Authorized Official
Title or Position : ADMINISTRATOR/CHIEF FINANCIAL OFFIC
Name : SAMSON ADEWOLE ADEDOKUN
Credential :
Telephone Number : 972-283-6100
Provider Enumeration Date : 05/04/2009
Last Update Date : 05/04/2009

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Directions to “CROWNDESEA HEALTH CARE ” Practice Location

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