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Organization
CRYSTAL EDGE 2 LLC
Active
Organization
CRYSTAL EDGE 2 LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HAJA UCHE MANAGER (OWNER)
(612) 459-2724
Entity
Organization
Contact information
Practice address
1979 WILSON AVE, SAINT PAUL, MN 55119-4046
(612) 459-2724
Mailing address
10616 KYLE AVE N, BROOKLYN PARK, MN 55443-1250
(612) 459-2724
(763) 208-0912
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Enumeration date
11/27/2024
Last updated
11/27/2024
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