Organization
FIRST CRYSTALCARE, INC.
Active
Other names
CrystalCare Health System
Organization subpart
No
Provider details
NPI number
Authorized official
KEYNA OMENUKOR RN (OWNER)
(972) 279-0682
Entity
Organization
Contact information
Practice address
1675 REPUBLIC PKWY STE 200C, MESQUITE, TX 75150-6903
(972) 279-0682
(972) 279-0689
Mailing address
1675 REPUBLIC PKWY STE 200C, MESQUITE, TX 75150-6903
(972) 279-0682
(972) 279-0689
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
—
—
251E00000X
Home Health Agency
Primary
—
—
251J00000X
Nursing Care Agency
—
—
253Z00000X
In Home Supportive Care Agency
—
—
3747A0650X
Attendant Care Provider
—
—
3747P1801X
Personal Care Attendant
—
—
374U00000X
Home Health Aide
—
—
376J00000X
Homemaker
—
—
385H00000X
Respite Care
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001026230
—
TX
Enumeration date
05/09/2007
Last updated
05/04/2026
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