Provider Demographics
NPI:1275670226
Name:CRESCENT HEALTH CARE, INC
Entity Type:Organization
Organization Name:CRESCENT HEALTH CARE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPHINE
Authorized Official - Middle Name:CYNTHIA
Authorized Official - Last Name:AKARUE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-207-5070
Mailing Address - Street 1:14905 SOUTHWEST FREEWAY
Mailing Address - Street 2:SUITE # 209
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77478
Mailing Address - Country:US
Mailing Address - Phone:281-207-5070
Mailing Address - Fax:
Practice Address - Street 1:14905 SOUTHWEST FWY
Practice Address - Street 2:SUITE 209
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478-5099
Practice Address - Country:US
Practice Address - Phone:281-207-5070
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-31
Last Update Date:2010-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX011178251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX743195Medicare Oscar/Certification