Organization
CRYSTALS KIDS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CRYSTAL C SMITH (OWNER)
(330) 284-5702
Entity
Organization
Contact information
Practice address
242 BELLFLOWER AVE NW, CANTON, OH 44708-5606
(330) 284-5702
Mailing address
242 BELLFLOWER AVE NW, CANTON, OH 44708-5606
(330) 284-5702
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
—
—
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
—
—
373H00000X
Day Training/Habilitation Specialist
Primary
—
—
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
—
—
Other
Enumeration date
07/21/2021
Last updated
07/21/2021
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