CRESCO CARE LLC
NPI 1730425240
Clinic/Center - Adolescent and Children Mental Health in Ooltewah, TN

Q: What is Cresco Care LLC's NPI number?

The NPI number for Cresco Care LLC is 1730425240. It was assigned to this organization in the NPPES registry on January 2, 2013.

Q: What is Cresco Care LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Adolescent and Children Mental Health, with taxonomy code 261QM0855X.

Q: When was this NPI record last updated?

The NPPES record for Cresco Care LLC was last updated on December 19, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since January 02, 2013

9465 HOMEWOOD CIR, OOLTEWAH, TN 37363(423) 200-4422 Get Directions Write a Review

NPPES record last updated: December 19, 2013. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Cresco Care Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CRESCO CARE LLC (NPI 1730425240) is a healthcare organization registered as an adolescent and children mental health in Ooltewah, Tennessee and active in the NPI registry since January 2013. The organization lists Anton Demenchuk, Executive Director, as its authorized official.

NPPES Registry Identity

NPI1730425240

Entity TypeOrganization

Primary Taxonomy261QM0855X

Legal Business NameCRESCO CARE LLC

Location Address9465 HOMEWOOD CIROoltewah, TN 37363-5105

Mailing AddressPo Box 1569, CollegedaleCollegedale, TN 37315-1569 · (646) 770-2691

Phone(423) 200-4422

Organization SubpartNo

Authorized OfficialAnton DemenchukExecutive Director · (646) 770-2691

Enumeration DateJanuary 2, 2013

Last NPPES UpdateDecember 19, 2013

✔ NPI 1730425240 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Adolescent and Children Mental HealthAmbulatory Health Care Facilities

Taxonomy Code261QM0855X

Definition

An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in children and adolescents. Services may be provided to parents and family members of the patient in the form of conjoint, group, or individual therapy, and education and/or training.

9465 HOMEWOOD CIR, Ooltewah, TN 37363

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Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Cresco Care LLC's NPI number?

The NPI number for Cresco Care LLC is 1730425240. It was assigned to this organization in the NPPES registry on January 2, 2013.

Where is Cresco Care LLC located?

Cresco Care LLC is located at 9465 Homewood Cir, Ooltewah, TN 37363. The listed phone number is (423) 200-4422.

What is Cresco Care LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Adolescent and Children Mental Health, with taxonomy code 261QM0855X.

When was this NPI record last updated?

The NPPES record for Cresco Care LLC was last updated on December 19, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.