# CRYSTAL HOME CARE AZ LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1679367510
- **Authorized official:** MENACHEM SHMUELI (MANAGING MEMBER)
- **Authorized official phone:** (917) 753-9089

## Contact information

- **Practice address:** 2025 N 3RD ST STE B300, PHOENIX, AZ 85004-1471
- **Practice address phone:** (602) 345-9299
- **Mailing address:** 1382 LANES MILL RD STE 104, LAKEWOOD, NJ 08701-3893

## Taxonomy

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

## Other

- **Enumeration date:** 04/07/2025
- **Last updated:** 04/24/2025