Provider Demographics
NPI:1346912235
Name:CHRISMA HOME CARE AGENCY
Entity Type:Organization
Organization Name:CHRISMA HOME CARE AGENCY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:IDELL
Authorized Official - Middle Name:A
Authorized Official - Last Name:STRACHAN
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:678-620-9121
Mailing Address - Street 1:6150 SEQUOIA LN
Mailing Address - Street 2:
Mailing Address - City:DOUGLASVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30135-5544
Mailing Address - Country:US
Mailing Address - Phone:678-642-3788
Mailing Address - Fax:904-800-1291
Practice Address - Street 1:6150 SEQUOIA LN
Practice Address - Street 2:
Practice Address - City:DOUGLASVILLE
Practice Address - State:GA
Practice Address - Zip Code:30135-5544
Practice Address - Country:US
Practice Address - Phone:678-642-3788
Practice Address - Fax:904-800-1291
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-29
Last Update Date:2021-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health