Provider Demographics
NPI:1669671939
Name:A CRESCENT HOME HEALTH, INC.
Entity Type:Organization
Organization Name:A CRESCENT HOME HEALTH, INC.
Other - Org Name:CRESCENT HOME HEALTH INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ALTAF
Authorized Official - Middle Name:N
Authorized Official - Last Name:VISRAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-414-5837
Mailing Address - Street 1:11251 NORTHWEST FWY
Mailing Address - Street 2:STE. 470
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77092-6529
Mailing Address - Country:US
Mailing Address - Phone:713-414-5837
Mailing Address - Fax:713-414-5452
Practice Address - Street 1:11251 NORTHWEST FWY
Practice Address - Street 2:STE. 470
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77092-6529
Practice Address - Country:US
Practice Address - Phone:713-414-5837
Practice Address - Fax:713-414-5452
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-16
Last Update Date:2024-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX012025251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX2150757-01Medicaid
747345OtherMEDICARE TYPE - UNSPECIFIED