Organization
CRYSTAL HEALTH CARE SERVICES, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. KATHRYN T WHITE (PRESIDENT, ADMINISTRATOR)
(704) 334-2311
Entity
Organization
Contact information
Practice address
1300 BAXTER STREET, SUITE 190, CHARLOTTE, NC 28204-3804
(704) 334-2311
(704) 334-2310
Mailing address
1300 BAXTER STREET, SUITE 190, CHARLOTTE, NC 28204-3804
(704) 334-2311
(704) 334-2310
Taxonomy
Speciality
Code
Description
License number
State
251J00000X
Nursing Care Agency
Primary
HC3464
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100589
—
NC
Enumeration date
10/03/2006
Last updated
08/05/2009
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