Provider Demographics
NPI:1083735591
Name:CROWN HOME HEALTH SERVICES
Entity Type:Organization
Organization Name:CROWN HOME HEALTH SERVICES
Other - Org Name:NNENNA ACHO
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:JACQUELYN
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-417-9901
Mailing Address - Street 1:921 CATTAIL DR
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76001-5912
Mailing Address - Country:US
Mailing Address - Phone:817-417-9901
Mailing Address - Fax:
Practice Address - Street 1:921 CATTAIL DR
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76001-5912
Practice Address - Country:US
Practice Address - Phone:817-417-9901
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-02
Last Update Date:2007-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX008457251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
679099Medicare Oscar/Certification