Organization
CRYSTAL CARE HOME HEALTH SERVICES, INC.
Active
Other names
Crystal Care Home Health Services, Inc.
Organization subpart
No
Provider details
NPI number
Authorized official
KEYNA N OMENUKOR RN (ADMINISTRATOR)
(972) 203-2121
Entity
Organization
Contact information
Practice address
1675 REPUBLIC PARKWAY, #200, MESQUITE, TX 75150
(972) 203-2121
(972) 203-8384
Mailing address
1675 REPUBLIC PARKWAY, #200, MESQUITE, TX 75150
(972) 203-2121
(972) 203-8384
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
006494
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000038800
—
TX
05
—
0008674000
—
TX
Enumeration date
08/12/2005
Last updated
10/31/2013
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