# CRYSTAL CARE NURSING AGENCY LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** CYSTAL CARE NURSING AGENCY
- **Organization subpart:** No

## Provider details

- **NPI number:** 1174287916
- **Authorized official:** MR. OLUTUNJI OLUJIDE MD (ADMINISTRATOR)
- **Authorized official phone:** (240) 898-7762

## Contact information

- **Practice address:** 11813 CHAREN LN, POTOMAC, MD 20854-3448
- **Practice address phone:** (240) 898-7762
- **Practice address fax:** (888) 872-7931
- **Mailing address:** 11813 CHAREN LN, POTOMAC, MD 20854-3448
- **Mailing address phone:** (240) 898-7762
- **Mailing address fax:** (888) 872-7931

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 10/27/2021
- **Last updated:** 01/26/2022