MEDICARE: CROWN HOME HEALTHCARE & PSYCH SERVICE MA INC

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

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1356780456
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CROWN HOME HEALTHCARE & PSYCH SERVICE MA INC

Provider Business Mailing Address
First Line	:	320 CENTRAL ST
Second Line	:	UNIT A2
City	:	SAUGUS
State	:	MA
Zip	:	01906-2371
Country	:	US
Telephone Number	:	781-233-2377
Fax Number	:	781-233-2399

Provider Business Practice Location Address
First Line	:	320 CENTRAL ST
Second Line	:	UNIT A2
City	:	SAUGUS
State	:	MA
Zip	:	01906-2371
Country	:	US
Telephone Number	:	781-233-2377
Fax Number	:	781-233-2399

Authorized Official
Title or Position	:	PRESIDENT
Name	:	EGHE OSAWE
Credential	:
Telephone Number	:	781-215-3815

Provider Enumeration Date	:	06/21/2013
Last Update Date	:	03/03/2015

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