Organization
DIVINE CRYSTAL CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CRYSTAL MOLINA LPN (OWNER)
(480) 341-7695
Entity
Organization
Contact information
Practice address
4110 W LAWRENCE LN, PHOENIX, AZ 85051-3664
(480) 341-7695
Mailing address
4110 W LAWRENCE LN, PHOENIX, AZ 85051-3664
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
—
—
251J00000X
Nursing Care Agency
—
—
253Z00000X
In Home Supportive Care Agency
Primary
—
—
385H00000X
Respite Care
—
—
385HR2055X
Child Mental Illness Respite Care
—
—
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
—
—
385HR2065X
Child Physical Disabilities Respite Care
—
—
Other
Enumeration date
05/17/2025
Last updated
05/17/2025
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