Provider Demographics
NPI:1659769438
Name:CRYSTAL ROSE HOME HEALTH CARE, INC
Entity Type:Organization
Organization Name:CRYSTAL ROSE HOME HEALTH CARE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT CFO
Authorized Official - Prefix:MS
Authorized Official - First Name:CORINNE
Authorized Official - Middle Name:
Authorized Official - Last Name:CHAVEZ-SERRANO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:661-949-8877
Mailing Address - Street 1:44841 DATE AVE
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93534-3102
Mailing Address - Country:US
Mailing Address - Phone:661-949-8877
Mailing Address - Fax:991-949-8810
Practice Address - Street 1:44841 DATE AVE
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93534-3102
Practice Address - Country:US
Practice Address - Phone:661-949-8877
Practice Address - Fax:991-949-8810
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-02
Last Update Date:2015-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health