Provider Demographics
NPI:1821233206
Name:CRESCENT HOME HEALTH CARE INC.
Entity type:Organization
Organization Name:CRESCENT HOME HEALTH CARE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MISS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:M
Authorized Official - Last Name:CHINNAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:708-268-4006
Mailing Address - Street 1:96 RIVER OAKS CENTER DR STE 211
Mailing Address - Street 2:
Mailing Address - City:CALUMET CITY
Mailing Address - State:IL
Mailing Address - Zip Code:60409-5504
Mailing Address - Country:US
Mailing Address - Phone:708-268-4006
Mailing Address - Fax:708-524-0514
Practice Address - Street 1:96 RIVER OAKS CENTER DR STE 211
Practice Address - Street 2:
Practice Address - City:CALUMET CITY
Practice Address - State:IL
Practice Address - Zip Code:60409-5504
Practice Address - Country:US
Practice Address - Phone:708-268-4006
Practice Address - Fax:708-524-0514
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-12
Last Update Date:2008-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health