Provider Demographics
NPI:1437757416
Name:CRYSTAL MINDS HELP L.L.C.
Entity Type:Organization
Organization Name:CRYSTAL MINDS HELP L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:YAIMARELYS
Authorized Official - Middle Name:
Authorized Official - Last Name:GRANDALES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-209-8996
Mailing Address - Street 1:1365 NW 127TH ST
Mailing Address - Street 2:
Mailing Address - City:NORTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33167-2205
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1365 NW 127TH ST
Practice Address - Street 2:
Practice Address - City:NORTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33167-2205
Practice Address - Country:US
Practice Address - Phone:786-209-8996
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-13
Last Update Date:2020-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care