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Organization

CRYSTAL BEACH VENTURES LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. MIKE WILLETT (PRESIDENT)
(713) 868-6112
Entity
Organization

Contact information

Practice address
2121 MARKET ST, SUITE 101, GALVESTON, TX 77550-1689
(409) 974-4935
(409) 632-7980
Mailing address
2121 MARKET ST, SUITE 101, GALVESTON, TX 77550-1689
(409) 974-4935
(409) 632-7980

Taxonomy

Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
017585
TX

Other

Enumeration date
10/14/2016
Last updated
10/14/2016
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