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Organization
CRYSTALHOMES LLC
Active
Organization
CRYSTALHOMES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
OLAJUMOKE O DISU (OWNER)
(651) 755-5026
Entity
Organization
Contact information
Practice address
4825 DOUGLAS DR N, CRYSTAL, MN 55429-3535
(651) 755-5026
Mailing address
4825 DOUGLAS DR N, CRYSTAL, MN 55429-3535
(651) 755-5026
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
3104A0625X
Assisted Living Facility (Mental Illness)
—
—
Other
Enumeration date
04/03/2026
Last updated
04/03/2026
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