Provider Demographics
NPI:1235865353
Name:CRESCENT HEALTH GROUP, LLC
Entity Type:Organization
Organization Name:CRESCENT HEALTH GROUP, LLC
Other - Org Name:CRESCENT HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SHALANDA
Authorized Official - Middle Name:RECHEL
Authorized Official - Last Name:JUDGE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:225-421-1921
Mailing Address - Street 1:8211 GOODWOOD BLVD STE A1
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70806-7740
Mailing Address - Country:US
Mailing Address - Phone:225-421-1921
Mailing Address - Fax:
Practice Address - Street 1:8211 GOODWOOD BLVD STE A1
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70806-7740
Practice Address - Country:US
Practice Address - Phone:225-421-1921
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-29
Last Update Date:2023-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Multi-Specialty
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)Group - Multi-Specialty