Community Residential Supportive Service Home Health Inc

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

Legal business name

COMMUNITY RESIDENTIAL SUPPORTIVE SERVICE HOME HEALTH INC

Doing business as

CRSS Home Health Inc

Practice address

2929 Breezewood Ave Ste 202
Fayetteville, NC 28303-5357

Phone

(910) 779-2944

NPI assigned

Jan 19, 2007

Organization subpart

No

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

Authorized official

Name

Terry Williams

Title

Administrator

Phone

(910) 658-7586

Specialties & licenses 2

Addresses

Other identifiers 9

Other names 1

• CRSS Home Health Inc Doing business as

Locations

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

{
    "created_epoch": "1169164800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701820800000",
    "number": "1972656577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2929 BREEZEWOOD AVE STE 202",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283035357",
            "telephone_number": "910-779-2944",
            "fax_number": "910-835-0361"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2929 BREEZEWOOD AVE STE 202",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283035357",
            "telephone_number": "910-779-2944"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "115 E Oak St",
            "address_purpose": "LOCATION",
            "city": "Selma",
            "state": "NC",
            "postal_code": "275762845",
            "country_code": "US",
            "telephone_number": "910-658-7586",
            "fax_number": "910-835-0361",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9711 David Taylor Dr Ste 164",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282622366",
            "country_code": "US",
            "telephone_number": "910-658-7586",
            "fax_number": "910-835-0361",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "102 S Wilson Ave Ste L",
            "address_purpose": "LOCATION",
            "city": "Dunn",
            "state": "NC",
            "postal_code": "283344960",
            "country_code": "US",
            "telephone_number": "910-779-2944",
            "fax_number": "910-835-0361",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "COMMUNITY RESIDENTIAL SUPPORTIVE SERVICE HOME HEALTH INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-19",
        "last_updated": "2023-12-06",
        "certification_date": "2023-12-06",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "TERRY",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "910-658-7586"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NC",
            "license": "HC2214",
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6600913",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "HC6832",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6600747",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "HC5970",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAP DA",
            "identifier": "3409290",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAP CH",
            "identifier": "6600913",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "HC1972",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "HC6940",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAP CHOICE",
            "identifier": "6600913",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CRSS Home Health Inc",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "CRSS Home Health Inc",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• In Home Supportive Care Agency in Fayetteville, NC
• Providers in Fayetteville, NC by specialty
• In Home Supportive Care Agency in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2023; 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.