Provider Demographics
NPI:1225874621
Name:CROWN HEALTH SERVICES LLC
Entity type:Organization
Organization Name:CROWN HEALTH SERVICES LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMIN
Authorized Official - Prefix:
Authorized Official - First Name:COMFORT
Authorized Official - Middle Name:
Authorized Official - Last Name:ADEOLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-744-9167
Mailing Address - Street 1:610 N HIGH SCHOOL RD STE B
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46214-3663
Mailing Address - Country:US
Mailing Address - Phone:317-744-9167
Mailing Address - Fax:317-981-1894
Practice Address - Street 1:610 N HIGH SCHOOL RD STE B
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46214-3663
Practice Address - Country:US
Practice Address - Phone:317-223-5648
Practice Address - Fax:317-981-1894
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-04
Last Update Date:2025-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health