Provider Demographics
NPI:1801194337
Name:CROWN HOME HEALTHCARE SERVICE INC
Entity Type:Organization
Organization Name:CROWN HOME HEALTHCARE SERVICE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:IKECHUKWU
Authorized Official - Middle Name:
Authorized Official - Last Name:UKOHA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-849-1286
Mailing Address - Street 1:121 LANSHIRE DR
Mailing Address - Street 2:
Mailing Address - City:ROCKWALL
Mailing Address - State:TX
Mailing Address - Zip Code:75032-4627
Mailing Address - Country:US
Mailing Address - Phone:972-849-1286
Mailing Address - Fax:
Practice Address - Street 1:121 LANSHIRE DR
Practice Address - Street 2:
Practice Address - City:ROCKWALL
Practice Address - State:TX
Practice Address - Zip Code:75032-4627
Practice Address - Country:US
Practice Address - Phone:972-849-1286
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-08
Last Update Date:2012-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health