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Organization

CRYSTAL EDGE LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
HAJA DEAN (DESIGNATED COORDINATOR)
(612) 459-2724
Entity
Organization

Contact information

Practice address
9119 REGENT PKWY, BROOKLYN PARK, MN 55443-1660
(612) 459-2724
Mailing address
9119 REGENT PKWY, BROOKLYN PARK, MN 55443-1660

Taxonomy

Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
310400000X
Assisted Living Facility
Primary

Other

Enumeration date
08/23/2022
Last updated
09/29/2023
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