Provider Demographics
NPI:1235201534
Name:RESIDENTIAL CRF,INC
Entity Type:Organization
Organization Name:RESIDENTIAL CRF,INC
Other - Org Name:RESIDENTIAL CRF,BAYVIEW
Other - Org Type:Doing Business As
Authorized Official - Title/Position:REGIONAL DIRECTOR
Authorized Official - Prefix:MISS
Authorized Official - First Name:MARLA
Authorized Official - Middle Name:J
Authorized Official - Last Name:COX
Authorized Official - Suffix:
Authorized Official - Credentials:BSW
Authorized Official - Phone:850-785-0605
Mailing Address - Street 1:700 W 23RD ST
Mailing Address - Street 2:SUITE 52
Mailing Address - City:PANAMA CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32405-3936
Mailing Address - Country:US
Mailing Address - Phone:850-785-0605
Mailing Address - Fax:850-785-8061
Practice Address - Street 1:2133 E 12TH ST
Practice Address - Street 2:
Practice Address - City:LYNN HAVEN
Practice Address - State:FL
Practice Address - Zip Code:32444-3109
Practice Address - Country:US
Practice Address - Phone:850-271-5071
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL4066095251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health