Provider Demographics
NPI:1518271923
Name:CR HOME HEALTHCARE LLC
Entity Type:Organization
Organization Name:CR HOME HEALTHCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:KAY
Authorized Official - Last Name:JANZ
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:608-924-0043
Mailing Address - Street 1:109 KEANE ST
Mailing Address - Street 2:
Mailing Address - City:RIDGEWAY
Mailing Address - State:WI
Mailing Address - Zip Code:53582-9784
Mailing Address - Country:US
Mailing Address - Phone:608-924-0043
Mailing Address - Fax:608-924-0021
Practice Address - Street 1:109 KEANE ST
Practice Address - Street 2:
Practice Address - City:RIDGEWAY
Practice Address - State:WI
Practice Address - Zip Code:53582-9784
Practice Address - Country:US
Practice Address - Phone:608-924-0043
Practice Address - Fax:608-924-0021
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-28
Last Update Date:2010-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI305985-31251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health