Crown Home Health Agency

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

CROWN HOME HEALTH AGENCY

Practice address

506 W Graham Ave Ste 206
Lake Elsinore, CA 92530-3667

Phone

(951) 610-7364

Fax

(858) 808-2891

NPI assigned

Nov 12, 2021

Last updated

Aug 20, 2024By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Christopher Menor

Title

Ceo

Phone

(442) 477-8172

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1073279139. Details of each certification follow.

• CCN 757548 Home health agency · Active · Details

Home health agency certification: CCN 757548

Legal name

CROWN HOME HEALTH AGENCY

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Feb 7, 2024

Last certification

Feb 1, 2024

Organization structure

CorporationProprietary

Incorporated

Jun 18, 2021 in CA

Enrollment address

506 W Graham Ave
Ste 206
Lake Elsinore, CA 92530-3667

Listed as

Crown Home Health AgencyCCN 757548 · All quality measures

Ownership

-

Certified

Feb 7, 2024

Medicare certification status

ActiveFrom the Provider of Services file

Locations

All disclosed owners & managing parties 2

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1636675200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724112000000",
    "number": "1073279139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1815 E WORKMAN AVE STE F",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917911423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "506 W GRAHAM AVE STE 206",
            "city": "LAKE ELSINORE",
            "state": "CA",
            "postal_code": "925303667",
            "telephone_number": "951-610-7364",
            "fax_number": "858-808-2891"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CROWN HOME HEALTH AGENCY",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-12",
        "last_updated": "2024-08-20",
        "certification_date": "2024-08-20",
        "status": "A",
        "authorized_official_last_name": "MENOR",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "442-477-8172"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• County of Riverside-Community Health Agency
• County of Riverside-Community Health Agency
• David Cox, ATC
• Sarah Cozart
• Danielle Cravalho
• Mayra Cruz
• Michelle Cruz, O.D.
• Tiffany Danielle Cue, CNA
• Adrienne Curayag, LMFT
• Adam Cutright

• Home Health Agency in Lake Elsinore, CA
• Providers in Lake Elsinore, CA by specialty
• Home Health Agency in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.