Organization
COMMUNITY RESIDENTIAL SUPPORTIVE SERVICE HOME HEALTH INC
Active
Other names
CRSS Home Health Inc
Organization subpart
No
Provider details
NPI number
Authorized official
TERRY WILLIAMS (ADMINISTRATOR)
(910) 658-7586
Entity
Organization
Contact information
Practice address
2929 BREEZEWOOD AVE STE 202, FAYETTEVILLE, NC 28303-5357
(910) 779-2944
Mailing address
2929 BREEZEWOOD AVE STE 202, FAYETTEVILLE, NC 28303-5357
(910) 779-2944
(910) 835-0361
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
HC2214
NC
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3409290
CAP DA
NC
05
—
6600747
—
NC
01
—
6600913
CAP CH
NC
05
—
6600913
—
NC
05
—
HC1972
—
NC
05
—
HC5970
—
NC
05
—
HC6832
—
NC
05
—
HC6940
—
NC
Enumeration date
01/19/2007
Last updated
12/06/2023
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