Provider Demographics
NPI:1225169535
Name:CRSE ADVANCED PLACEMENT HOMES, INC.
Entity Type:Organization
Organization Name:CRSE ADVANCED PLACEMENT HOMES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:RAY
Authorized Official - Last Name:STEWART
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-722-1862
Mailing Address - Street 1:2295 E 14TH ST
Mailing Address - Street 2:SUITE 400
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27105-6804
Mailing Address - Country:US
Mailing Address - Phone:336-722-1862
Mailing Address - Fax:336-722-1863
Practice Address - Street 1:2295 E 14TH ST
Practice Address - Street 2:SUITE 400
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27105-6804
Practice Address - Country:US
Practice Address - Phone:336-722-1862
Practice Address - Fax:336-722-1863
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-08
Last Update Date:2009-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8301202Medicaid