# STONECREST MEDICAL AND REHAB. CENTER, DBA CLASSIC HOMEHEALTH AGENCY

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1790704989
- **Authorized official:** JADE U IRONDI (ALT ADMINISTRATOR/CFO)
- **Authorized official phone:** (972) 274-1205

## Contact information

- **Practice address:** 405 SUMMERTREE LN, DESOTO, TX 75115-5840
- **Practice address phone:** (972) 274-1205
- **Practice address fax:** (469) 643-6404
- **Mailing address:** 405 SUMMERTREE LN, DESOTO, TX 75115-5840
- **Mailing address phone:** (972) 274-1205
- **Mailing address fax:** (469) 643-6404

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 372500000X | Chore Provider | 010430 | TX | Yes |

## Other

- **Enumeration date:** 07/19/2006
- **Last updated:** 08/22/2020