Provider Demographics
NPI:1235136227
Name:CROWLEY HOME HEALTH SERVICES, INC.
Entity Type:Organization
Organization Name:CROWLEY HOME HEALTH SERVICES, INC.
Other - Org Name:PROFESSIONAL HOME HEALTH OF SOUTHWEST LA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:LANCE
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:318-448-0891
Mailing Address - Street 1:538 S.E. CT. CIRCLE
Mailing Address - Street 2:
Mailing Address - City:CROWLEY
Mailing Address - State:LA
Mailing Address - Zip Code:70526
Mailing Address - Country:US
Mailing Address - Phone:337-783-5040
Mailing Address - Fax:337-783-5041
Practice Address - Street 1:538 S.E. CT. CIRCLE
Practice Address - Street 2:
Practice Address - City:CROWLEY
Practice Address - State:LA
Practice Address - Zip Code:70526
Practice Address - Country:US
Practice Address - Phone:337-783-5040
Practice Address - Fax:337-783-5041
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-05
Last Update Date:2018-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA25251E00000X
251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1400246Medicaid
LA1400246Medicaid