Provider Demographics
NPI:1689063018
Name:CRYSTAL HOME HEALTH CARE
Entity Type:Organization
Organization Name:CRYSTAL HOME HEALTH CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ELON
Authorized Official - Middle Name:
Authorized Official - Last Name:MWAURA
Authorized Official - Suffix:
Authorized Official - Credentials:PA-C
Authorized Official - Phone:412-641-9898
Mailing Address - Street 1:245 W BRUCETON RD
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15236-4237
Mailing Address - Country:US
Mailing Address - Phone:412-641-9898
Mailing Address - Fax:
Practice Address - Street 1:245 W BRUCETON RD
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15236-4237
Practice Address - Country:US
Practice Address - Phone:412-641-9898
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-22
Last Update Date:2015-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA4322279251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health