Organization
CRYSTAL PROPERTIES INC.
Active
Other names
Pleasant Park Estates
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RANDY LANGE (PRESIDENT/CEO)
(515) 223-0758
Entity
Organization
Contact information
Practice address
1514 HIGH AVE W, OSKALOOSA, IA 52577-1944
(641) 673-7032
(641) 673-7723
Mailing address
1514 HIGH AVE W, OSKALOOSA, IA 52577-1944
(641) 673-7032
(641) 673-7723
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
620049
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
16E722
STATE DIA NUMBER
IA
01
—
620049
STATE LICENSE NUMBER
IA
05
—
I-0809772
—
IA
Enumeration date
05/17/2006
Last updated
02/13/2008
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