Organization
CRYSTAL GLARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GRACE SENTAMU (C.E.O)
(734) 444-7465
Entity
Organization
Contact information
Practice address
9542 W PICKWICK CIR, TAYLOR, MI 48180-3816
(734) 444-7465
Mailing address
9542 W PICKWICK CIR, TAYLOR, MI 48180-3816
(734) 444-7465
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Enumeration date
03/06/2018
Last updated
03/06/2018
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