Provider Demographics
NPI:1174138416
Name:CROSSLEY SENIORCARE LLC
Entity type:Organization
Organization Name:CROSSLEY SENIORCARE LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:MARK
Authorized Official - Last Name:CROSSLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-687-0367
Mailing Address - Street 1:4321 S LEE ST STE 400
Mailing Address - Street 2:
Mailing Address - City:BUFORD
Mailing Address - State:GA
Mailing Address - Zip Code:30518-5776
Mailing Address - Country:US
Mailing Address - Phone:678-565-6500
Mailing Address - Fax:
Practice Address - Street 1:4321 S LEE ST STE 400
Practice Address - Street 2:
Practice Address - City:BUFORD
Practice Address - State:GA
Practice Address - Zip Code:30518-5776
Practice Address - Country:US
Practice Address - Phone:678-565-6500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-14
Last Update Date:2023-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care