Provider Demographics
NPI:1871005306
Name:CRN HEALTHCARE, INC.
Entity Type:Organization
Organization Name:CRN HEALTHCARE, INC.
Other - Org Name:CRN OF WARREN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BUSINESS MANAGER/CLINICAL MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:KEITH
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:VUKASINOVICH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:937-672-1424
Mailing Address - Street 1:201 W. FRANKLIN STREET
Mailing Address - Street 2:SUITE B
Mailing Address - City:CENTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45459
Mailing Address - Country:US
Mailing Address - Phone:937-672-1424
Mailing Address - Fax:234-806-4504
Practice Address - Street 1:201 W. FRNAKLIN STREET
Practice Address - Street 2:SUITE B
Practice Address - City:CENTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:45459
Practice Address - Country:US
Practice Address - Phone:937-672-1424
Practice Address - Fax:234-806-4504
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-24
Last Update Date:2023-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0258381Medicaid