Provider Demographics
NPI:1003576893
Name:CRENSHAW HEALTHCARE
Entity Type:Organization
Organization Name:CRENSHAW HEALTHCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ARSEN
Authorized Official - Middle Name:
Authorized Official - Last Name:DILANYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:754-230-8888
Mailing Address - Street 1:14222 VICTORY BLVD SUITE 411C
Mailing Address - Street 2:
Mailing Address - City:NORTH HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:91606
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:14222 VICTORY BLVD SUITE 411C
Practice Address - Street 2:
Practice Address - City:NORTH HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:91606
Practice Address - Country:US
Practice Address - Phone:754-230-8888
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-21
Last Update Date:2021-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health