Provider Demographics
NPI:1356780456
Name:CROWN HOME HEALTHCARE & PSYCH SERVICE MA INC
Entity type:Organization
Organization Name:CROWN HOME HEALTHCARE & PSYCH SERVICE MA INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:EGHE
Authorized Official - Middle Name:
Authorized Official - Last Name:OSAWE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:781-215-3815
Mailing Address - Street 1:320 CENTRAL ST
Mailing Address - Street 2:UNIT A2
Mailing Address - City:SAUGUS
Mailing Address - State:MA
Mailing Address - Zip Code:01906-2371
Mailing Address - Country:US
Mailing Address - Phone:781-233-2377
Mailing Address - Fax:781-233-2399
Practice Address - Street 1:320 CENTRAL ST
Practice Address - Street 2:UNIT A2
Practice Address - City:SAUGUS
Practice Address - State:MA
Practice Address - Zip Code:01906-2371
Practice Address - Country:US
Practice Address - Phone:781-233-2377
Practice Address - Fax:781-233-2399
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-21
Last Update Date:2015-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110101460AMedicaid
MA227591Medicare Oscar/Certification