CRESCENT HOME ADULT CARE FACILITYINC NPI 1336283985

NPI Information

NPI: 1336283985
Provider Name: CRESCENT HOME ADULT CARE FACILITY,INC

Other Name: CRESCENT HOME

Classification: Lodging - 177F00000X
Entity Type: Organization

Address:
812 W COLORADO AVE
COLORADO SPRINGS, CO
ZIP 80905
Phone: (719) 634-2237
Get Directions

CRESCENT HOME ADULT CARE FACILITY,INC is a lodging in Colorado Springs, CO. The provider is a public or privately owned facility providing overnight lodging to individuals traveling long distances or receiving prolonged outpatient medical services away from home. CRESCENT HOME ADULT CARE FACILITY,INC NPI is 1336283985. The provider is registered as an organization entity type and is a single specialty group.
The provider Other Name Is Crescent Home.

The provider's business location address is:

812 W COLORADO AVE
COLORADO SPRINGS, CO
ZIP 80905-516
Phone: (719) 634-2237
Fax: (719) 634-2471

The provider's authorized official is Nancy V. Saiz .
The authorized official title is Director and has the following contact phone number (719) 634-2237.

The CLIA number assigned to this NPI record is 06D2230308 - assisted living facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/16/2007 and was last updated on 8/22/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	177F00000X	Lodging		AL-0984	COLORADO	Yes
2	320800000X	Community Based Residential Treatment Facility, Mental Illness		AL-0984	COLORADO	X

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	66422540	MEDICAID	COLORADO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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