Provider Demographics
NPI:1043913585
Name:CRISS HOME HEALTH CARE SERVICES LLC
Entity type:Organization
Organization Name:CRISS HOME HEALTH CARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:MS
Authorized Official - First Name:ADENIKE
Authorized Official - Middle Name:M
Authorized Official - Last Name:MORMAH
Authorized Official - Suffix:
Authorized Official - Credentials:MANAGING OWNER
Authorized Official - Phone:302-510-3610
Mailing Address - Street 1:3935 SADIE RD
Mailing Address - Street 2:
Mailing Address - City:RANDALLSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21133-4010
Mailing Address - Country:US
Mailing Address - Phone:302-510-3610
Mailing Address - Fax:443-792-0078
Practice Address - Street 1:3935 SADIE RD
Practice Address - Street 2:
Practice Address - City:RANDALLSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21133-4010
Practice Address - Country:US
Practice Address - Phone:302-510-3610
Practice Address - Fax:443-792-0078
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-23
Last Update Date:2024-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty