MEDICARE: CRESCENT HOME HEALTH LLC

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	3747P1801X	Personal Care Attendant
2	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	:	1659241750
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CRESCENT HOME HEALTH LLC

Provider Business Mailing Address
First Line	:	42871 IRON BIT PL
Second Line	:
City	:	CHANTILLY
State	:	VA
Zip	:	20152-6365
Country	:	US
Telephone Number	:	703-829-6355
Fax Number	:

Provider Business Practice Location Address
First Line	:	42871 IRON BIT PL
Second Line	:
City	:	CHANTILLY
State	:	VA
Zip	:	20152-6365
Country	:	US
Telephone Number	:	703-829-6355
Fax Number	:

Authorized Official
Title or Position	:	OWNER/ADMINISTRATOR
Name	:	MAHAD FARAH
Credential	:
Telephone Number	:	703-829-6355

Provider Enumeration Date	:	11/05/2025
Last Update Date	:	12/09/2025

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Directions to “CRESCENT HOME HEALTH LLC ” Practice Location

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