Provider Demographics
NPI:1649360611
Name:CRISKEL HOME HEALTH, INC.
Entity type:Organization
Organization Name:CRISKEL HOME HEALTH, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:KELECHI
Authorized Official - Middle Name:N
Authorized Official - Last Name:OGBUEHI
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:214-660-9382
Mailing Address - Street 1:1221 ABRAMS RD STE 105
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75081-5581
Mailing Address - Country:US
Mailing Address - Phone:214-660-9382
Mailing Address - Fax:214-660-3727
Practice Address - Street 1:1221 ABRAMS RD STE 105
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75081-5581
Practice Address - Country:US
Practice Address - Phone:214-660-9382
Practice Address - Fax:214-660-3727
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-13
Last Update Date:2012-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX010036163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WH0200XNursing Service ProvidersRegistered NurseHome HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX679557Medicare ID - Type UnspecifiedISSUED BY PALMETTO DBA