Crosby Community Home Inc

Primary specialty

Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X

License

0000753901 Issued in TX

Legal business name

CROSBY COMMUNITY HOME INC

Practice address

112 S Ward Dr
Longview, TX 75604

Phone

(903) 295-7391

Fax

(903) 295-7395

NPI assigned

May 23, 2006

Last updated

Aug 22, 2020By 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

Mr. Howard Wayne Pecot

Title

President

Phone

(903) 295-7391

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1148342400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1427003292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 S WARD DR",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "75604",
            "telephone_number": "903-295-7391",
            "fax_number": "903-295-7395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 S WARD DR",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "75604",
            "telephone_number": "903-295-7391",
            "fax_number": "903-295-7395"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CROSBY COMMUNITY HOME INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-23",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PECOT",
        "authorized_official_first_name": "HOWARD",
        "authorized_official_middle_name": "WAYNE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "903-295-7391",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": "TX",
            "license": "0000753901",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Creative Motion, Inc
• Crestcare Nursing & Rehabilitation Center (Eden Specialty Care)
• CRH of Longview LLC (Longview Rehabilitation Hospital)
• Hannah Crisp, OT
• Christina Lea Croley, FNP-C
• Alexa Crosby
• Chad Crossland
• Madison Taylor Crow, FNP-C
• Steven N Crump, DDS
• Charles Prentice Crumpler, M.D.

• Intellectual Disabilities Intermediate Care Facility in Longview, TX
• Providers in Longview, TX by specialty
• Intellectual Disabilities Intermediate Care Facility in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.