Provider Demographics
NPI:1649419128
Name:CROWN HOME HEALTH CORP
Entity Type:Organization
Organization Name:CROWN HOME HEALTH CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:ROCHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:MENDOZA
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:951-397-9938
Mailing Address - Street 1:1411 RIMPAU AVE
Mailing Address - Street 2:SUITE 204
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92879-2693
Mailing Address - Country:US
Mailing Address - Phone:951-734-1200
Mailing Address - Fax:951-734-1201
Practice Address - Street 1:1411 RIMPAU AVE
Practice Address - Street 2:SUITE 204
Practice Address - City:CORONA
Practice Address - State:CA
Practice Address - Zip Code:92879-2693
Practice Address - Country:US
Practice Address - Phone:951-734-1200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-06
Last Update Date:2021-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health