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Organization
CRYSTAL HEALTH & REHAB OF GREENWOOD, LLC
Active
Organization
CRYSTAL HEALTH & REHAB OF GREENWOOD, LLC
Active
Parent organization
COVENANT DOVE, LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
COVENANT DOVE, LLC
Authorized official
CHRISTOPHER J MURPHY (VICE PRESIDENT)
(901) 937-7994
Entity
Organization
Contact information
Practice address
902 SGT JOHN A PITTMAN DR, GREENWOOD, MS 38930-7343
(662) 453-9173
(662) 455-4933
Mailing address
902 SGT JOHN A PITTMAN DR, GREENWOOD, MS 38930-7343
(662) 453-9173
(662) 455-4933
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
—
—
225X00000X
Occupational Therapist
Primary
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
06002269
—
MS
Enumeration date
12/16/2009
Last updated
04/12/2012
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