Provider Demographics
NPI:1578067302
Name:CROWDER'S INDEPENDENT LIVING
Entity Type:Organization
Organization Name:CROWDER'S INDEPENDENT LIVING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROSIE
Authorized Official - Middle Name:
Authorized Official - Last Name:CROWDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-701-0042
Mailing Address - Street 1:12722 CAPE HYANNIS DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77048-4008
Mailing Address - Country:US
Mailing Address - Phone:832-329-0285
Mailing Address - Fax:713-513-5289
Practice Address - Street 1:8018 JUTLAND RD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77033-2904
Practice Address - Country:US
Practice Address - Phone:281-701-0042
Practice Address - Fax:713-513-5289
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-18
Last Update Date:2018-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health