Home Health Crusaders, Inc.

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

060094041 Issued in IN

Legal business name

HOME HEALTH CRUSADERS, INC.

Practice address

3191 Willowcreek Rd
Portage, IN 46368-4446

Phone

(219) 763-0404

Fax

(219) 209-9170

NPI assigned

Mar 30, 2007

Last updated

Jul 6, 2015By 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

Mrs. Deanna M Memon

Title

Administrator

Phone

(219) 763-0404

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1811017965. Details of each certification follow.

• CCN 157471 Home health agency · Active · Details

Home health agency certification: CCN 157471

Legal name

HOME HEALTH CRUSADERS INC

Certification status

Active

Provider type (POS)

Home health agency

Participating since

May 6, 1996

Last certification

Aug 22, 2019

Ownership / control type

Proprietary

Organization structure

CorporationProprietary

Incorporated

Nov 22, 1995 in IN

Enrollment address

3191 Willowcreek Rd
Portage, IN 46368-4446

Listed as

Home Health Crusaders IncCCN 157471 · All quality measures

Overall star rating

3 of 5

Ownership

Proprietary

Certified

May 6, 1996

Medicare certification status

ActiveFrom the Provider of Services file

Services

Nursing, Medical social, Physical therapy, Speech pathology, Occupational therapy

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

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": "1175212800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1436140800000",
    "number": "1811017965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3191 WILLOWCREEK RD",
            "city": "PORTAGE",
            "state": "IN",
            "postal_code": "463684446",
            "telephone_number": "219-763-0404",
            "fax_number": "219-209-9170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3191 WILLOWCREEK RD",
            "city": "PORTAGE",
            "state": "IN",
            "postal_code": "463684446",
            "telephone_number": "219-763-0404",
            "fax_number": "219-209-9170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOME HEALTH CRUSADERS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-30",
        "last_updated": "2015-07-06",
        "status": "A",
        "authorized_official_last_name": "MEMON",
        "authorized_official_first_name": "DEANNA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "219-763-0404",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "IN",
            "license": "060094041",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200097310A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Home Health Agency in Portage, IN
• Providers in Portage, IN by specialty
• Home Health Agency in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2015; 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.