Provider Demographics
NPI:1699555326
Name:CRYSTAL CARE, LLC
Entity type:Organization
Organization Name:CRYSTAL CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EMAN
Authorized Official - Middle Name:
Authorized Official - Last Name:ABDURAHMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-207-1171
Mailing Address - Street 1:301 S PERIMETER PARK DR STE 100
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37211-4128
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:301 S PERIMETER PARK DR
Practice Address - Street 2:STE 100
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37211
Practice Address - Country:US
Practice Address - Phone:615-710-7534
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-02
Last Update Date:2024-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care