Organization
CRYSTAL HOME CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MONA B ALI RN (PRESIDENT)
(816) 474-1814
Entity
Organization
Contact information
Practice address
4001 BLUE PKWY STE 101, KANSAS CITY, MO 64130-2350
(816) 474-1814
(816) 474-1861
Mailing address
4001 BLUE PKWY STE 101, KANSAS CITY, MO 64130-2350
(816) 474-1814
(816) 474-1861
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
19677111
MO
372500000X
Chore Provider
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
19677111
MISSOURI EMPLOYER IDENTIF
MO
Enumeration date
10/23/2007
Last updated
04/02/2019
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