Provider Demographics
NPI:1306429105
Name:CRESCENT HOME CARE LLC
Entity type:Organization
Organization Name:CRESCENT HOME CARE LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ABDULQADIR
Authorized Official - Middle Name:
Authorized Official - Last Name:SHIRDON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-285-9233
Mailing Address - Street 1:6161 BUSCH BLVD STE 304
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43229-2555
Mailing Address - Country:US
Mailing Address - Phone:614-598-6744
Mailing Address - Fax:
Practice Address - Street 1:6161 BUSCH BLVD STE 304
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43229-2555
Practice Address - Country:US
Practice Address - Phone:614-598-6744
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-30
Last Update Date:2025-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health