MEDICARE: CRUM COMPASSIONATE HOME CARE 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	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1780530196
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CRUM COMPASSIONATE HOME CARE LLC

Provider Business Mailing Address
First Line	:	330 S HAGUE AVE
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43204-3006
Country	:	US
Telephone Number	:	614-254-7904
Fax Number	:

Provider Business Practice Location Address
First Line	:	330 S HAGUE AVE
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43204-3006
Country	:	US
Telephone Number	:	614-254-7904
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	SHALISSA CRUM
Credential	:
Telephone Number	:	614-254-7904

Provider Enumeration Date	:	03/09/2026
Last Update Date	:	03/09/2026

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