Provider Demographics
NPI:1043910763
Name:CREST HOME CARE LLC
Entity Type:Organization
Organization Name:CREST HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:RADHIKA
Authorized Official - Middle Name:
Authorized Official - Last Name:CHUWAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-330-7488
Mailing Address - Street 1:2210 BERKSHIRE RD
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17603-6104
Mailing Address - Country:US
Mailing Address - Phone:717-330-7488
Mailing Address - Fax:
Practice Address - Street 1:2210 BERKSHIRE RD
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17603-6104
Practice Address - Country:US
Practice Address - Phone:717-330-7488
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-09
Last Update Date:2023-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No385H00000XRespite Care FacilityRespite Care