Provider Demographics
NPI: | 1467128397 |
---|---|
Name: | CROWN HOSPICE, INC. |
Entity Type: | Organization |
Organization Name: | CROWN HOSPICE, INC. |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | ADMINISTRATION |
Authorized Official - Prefix: | |
Authorized Official - First Name: | ADWOA SERWA |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | OSEI NYARKO |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 661-313-9592 |
Mailing Address - Street 1: | 6400 E WASHINGTON BLVD STE 107D |
Mailing Address - Street 2: | |
Mailing Address - City: | COMMERCE |
Mailing Address - State: | CA |
Mailing Address - Zip Code: | 90040-1820 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 562-395-7670 |
Mailing Address - Fax: | 562-395-7671 |
Practice Address - Street 1: | 6400 E WASHINGTON BLVD STE 107D |
Practice Address - Street 2: | |
Practice Address - City: | COMMERCE |
Practice Address - State: | CA |
Practice Address - Zip Code: | 90040-1820 |
Practice Address - Country: | US |
Practice Address - Phone: | 562-395-7670 |
Practice Address - Fax: | 562-395-7671 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2021-08-20 |
Last Update Date: | 2021-08-20 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 251G00000X | Agencies | Hospice Care, Community Based | |
No | 251B00000X | Agencies | Case Management | |
No | 251F00000X | Agencies | Home Infusion |