Crestcare Nursing & Rehabilitation Center

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

110571 Issued in TX

Legal business name

CRESTCARE NURSING & REHABILITATION CENTER

Practice address

1301 Eden Dr
Longview, TX 75605-4102

Phone

(903) 753-7651

Fax

(903) 758-8942

NPI assigned

Oct 27, 2005

Organization subpart

No

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

Authorized official

Name

Mr. Leroy Williams

Title

President

Phone

(281) 574-7495

Specialties & licenses 3

Addresses

Other identifiers 2

Other names 1

• Eden Specialty Care Doing business as

Locations

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

{
    "created_epoch": "1130371200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1372723200000",
    "number": "1619967932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 EDEN DR",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756054102",
            "telephone_number": "903-753-7651",
            "fax_number": "903-758-8942"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 EDEN DR",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756054102",
            "telephone_number": "903-753-7651",
            "fax_number": "903-758-8942"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRESTCARE NURSING & REHABILITATION CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-27",
        "last_updated": "2013-07-02",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "LEROY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "281-574-7495",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "TX",
            "license": "110571",
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "TX",
            "license": "110571",
            "primary": true
        },
        {
            "code": "385H00000X",
            "taxonomy_group": "",
            "desc": "Respite Care",
            "state": "TX",
            "license": "110571",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001003848",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1668709-01",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Eden Specialty Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Angela Dawn Craver, H.I.S.
• Grace Florence Crawford, PTA
• Amy Berlynne Creamer, MA, NCC, LPC
• Creative Motion Pediatric Therapy
• Creative Motion, Inc
• CRH of Longview LLC
• Hannah Crisp, OT
• Christina Lea Croley, FNP-C
• Crosby Community Home Inc
• Alexa Crosby

• Skilled Nursing Facility in Longview, TX
• Providers in Longview, TX by specialty
• Skilled Nursing Facility in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2013; 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.