Provider Demographics
NPI:1720877533
Name:CRESCENT CARE, LLC
Entity type:Organization
Organization Name:CRESCENT CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:IKRAN
Authorized Official - Middle Name:
Authorized Official - Last Name:HAJI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-330-9875
Mailing Address - Street 1:2862 JOHNSTOWN RD STE 112
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43219-1793
Mailing Address - Country:US
Mailing Address - Phone:614-330-9876
Mailing Address - Fax:614-330-9876
Practice Address - Street 1:2862 JOHNSTOWN RD STE 112
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43219-1793
Practice Address - Country:US
Practice Address - Phone:614-330-9876
Practice Address - Fax:614-330-9876
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-06
Last Update Date:2025-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health