Organization
CRYSTAL SPRINGS HOME, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FREDERICKA WAGNER (EXECUTIVE DIRECTOR)
(740) 493-2380
Entity
Organization
Contact information
Practice address
799 MOUNT ETNA RD, PIKETON, OH 45661-1101
(740) 493-2380
Mailing address
PO BOX 845, PIKETON, OH 45661-0845
(740) 493-2380
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
12/27/2020
Last updated
12/30/2020
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