Provider Demographics
NPI:1114491867
Name:CHARLES CRAIG HOME CARE INC
Entity Type:Organization
Organization Name:CHARLES CRAIG HOME CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT / OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:J
Authorized Official - Last Name:CRAIG
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:516-448-8631
Mailing Address - Street 1:63 YOUNGS HILL RD
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:11743-2154
Mailing Address - Country:US
Mailing Address - Phone:516-448-8631
Mailing Address - Fax:
Practice Address - Street 1:63 YOUNGS HILL RD
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:NY
Practice Address - Zip Code:11743-2154
Practice Address - Country:US
Practice Address - Phone:516-448-8631
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-16
Last Update Date:2019-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
251E00000XOtherCOMPANION CARE